A case in point

[Guest guest]

Thank you for this well-thought, eloquent, and logical post, Kath. I agree with

it - every single word.

 

 

 

" " wrote: whew! just got to the end

of this thread. you boys have really been going

at it. David, can i just say, without meaning to put you on the defensive,

relax a little. i know you want to keep the discussion on topic, and not

get personal, but i have noticed through this whole ABORM debate that you

(and others) have tendency to get on the attack. i have felt it.

 

this is a really contentious issue. exploring the ramifications is

important. it gets emotional, because most of us are pretty passionate

about our practice of the medicine and the direction the profession is

going. david raised a strong point about listening and not just trolling

for points to debunk. i think it would be helpful if we (myself

included) could try to hear the others point of view, consider and respond

to that, rather than continuing to push our perspective. i think we've all

staked out our positions really well, so that there is no misunderstanding

about who's on what side of the fence on this. so i'm doubtful any of us

will be successful at 'converting an opponent'. let's keep this

debate friendly and amicable, we're all colleagues.

 

ok, now that that's off my chest, a few points on topic:

 

earlier on hugo made some points about effectiveness of ART.

 

i seem to recall reading some stats about IVF a few months ago on line (not

sure where) showing that it was under 20% effective (i recall a % in the low

teens). does my memory fail? i remember being shocked at this, esp.

considering the high cost of such an ineffective tx. and thinking if our

medicine was that ineffective we'ld never be able to even get a license to

practice, let along open our doors for business. does someone have an

accurate stat on the effectiveness of IVF they could provide? it would also

be interesting to see how much it's increased when acu is added (i recall

that success of IVF increases exponentially).

 

secondly:

 

the debate seems to have strayed from the org topic of certification to the

wider issue of specialization. although linked, i would point out that

these are different issues. (point of clarification). although they are

tied together since we're discussing a certification as a specialist.

 

i think that's part of the problem here, whether passing this test created

by a self appointed board with no oversight qualifies one as a specialist.

(no documentation of coursework or supervised clinical training is

necessary).

 

 

thirdly:

 

david: you presented a passionate argument about the knowledge of a

reproductive acu. and i see your point as to wanting to distinguish your

depth of knowledge in this field from a generalist, and am contemplating it.

 

 

a couple of points about this issue:

 

 

1. i like the term you threw in, reproductive acupuncturist. i might

address this query to mike b: is there any issue against someone like david

(who tx 95% infertility and clearly is accumulating an expertise in the

field), in absence of a $1000 certificate, or a DAOM in infertility, as

noting him/herself as a reproductive acupuncturist? i'm thinking in

marketing materials (since the 'need' for the cert seems to have much to do

with marketing) such as bus cards, website, etc.

2. on the DAOM: mike, i agree, in the future, that is the way to go:

it's legit and provides no doubt of adv. training in the field. but i hear

david, for the present moment, the initial students are beta testers for the

programs. i for one would also not consider enrolling in a DAOM program for

that reason. i also would expect to get a quality of classes from the DAOM

programs that is not yet developed.

3. this leads me back to a point i made early on: we have to accept

that we are pioneers in a developing profession. that means to me that

unfortunately people like david (or Dr. wannabees) don't get the titles yet

because the profession hasn't gotten that far.

4. Ray Rubio made some points who's logic i didn't quite agree with.

he said that when orgs like aaom and nccaom were formed, there weren't other

orgs to oversee them, so a group of practitioner's just got together and

started them, like what ABORM is doing. the difference is (and the flaw

in his logic) is that now we do have other orgs in place, and ABORM has leap

frogged over the proper channels in their (well meaning) haste to get their

$1000 certificate in place. there's a couple of real problems here for me.

 

 

Firstly, they are starting a precedent for other specialty wannabee's to

follow their models. regardless of whether or not their particular 'board'

is justifiable, it starts a precedent for others. this is truly problematic

since they have not gone through the proper channels to do this, and they

are opening the door for others to follow in their footsteps.

 

secondly, on this issue of going through the NCCA (do i have that one right,

the nat cert commiss?), he said they would get to that down the road. well

i think they are being too hasty about pushing out their product, they

should be working on the NCCA cert now, not as a later afterthought.

 

he said that when they first came up with the idea for ABORM the DAOM

programs weren't started yet. well, first, they knew the programs were on

the way. and second, they are out now, and in fact there is one in

infertility. so why not put their efforts into supporting/developing a

stellar DAOM in infertility rather that their quasi specialty certification

(quasi because it's unapproved by any kind of oversight, doesn't require

coursework or supervised clinical hours)? or put the energy into getting the

channels in place to support development of legitimit specialties.

 

on the issue of clinical training: he says they would work to develop

residencies. a medical specialty includes coursework and clinical

training. they've put the cart before the horse, putting out a specialty

certificate without documentation of coursework or clinical training. they

need to first get the coursework and clinical training in place, then

document it with a specialty. i don't think the argument that right now all

we have is a few ceu classes, a few fertility classes in the colleges and no

clinical training in the field holds water for putting out a specialty that

doesn't document these things. i believe their effort should properly be

goiing into getting these things in place first, and then documenting it

with a certificate or specialty title.

 

while i acknowledge their spunk and tenacity in seeing a problem/need and

rolling up their sleeves and solving it, i don't agree with taking it upon

themselves to put out a specialty certification without working with their

colleagues in the profession to see if others agree that this is the best

solution to the 'problem'.

 

i think this is part of the crux of the opposition to ABORM. that they

did not openly discuss their plans with the acu community, ask for comment,

work with the orgs and the community to see if others in the profession were

on board with their plan, etc. to me, i find it galling that they decided

that they know what's best and implemented it, without any kind of public

comment. they're not an org or a cert. body, they're just a group of people

with a collective body of knowledge in the field. but that doesn't justify

that this small group of [respected] colleagues knows what's best for the

profession and has the best solution for the problem they see. and that

this small group of colleagues implements something that could have huge

ramifications for the profession, without even caring to find out what the

rest of us think should be done or if we agree and want their solution.

 

this is problematic for me on many levels.

 

so what i hear from the repro acu's who support ABORM is that they do so

because they want acknowledgement of their niche practice. there are other

ways to convey this to the west med community and the gen public. but what

the supporters do not seem to get past is the larger ramifications of what

implementing this specialty certification in this manner means to the

profession and practice of tcm in the US.

 

so i think there are 2 major categories of issues here: specialties and

certifications, and the ramifications of what ABORM is doing by implementing

their specialty certification in this matter.

 

lastly: i would like to direct a comment to something david said earlier, in

his argument for a repro acu specialist: that a generalist wouldn't know how

to dx or tx adv or complicated conditions, or when to refer out. i agree

with your train of thought, that there's much a repro acu knows about the

field that a generalist doesn't, however, that doesn't mean that a

generalist doesn't know when to refer out, or, as hugo pointed out, do the

research to figure out how to tx the case. and i think that is a flaw in

your logic.

 

ok guys, be gentle.

 

kb

 

 

 

 

Fussy? Opinionated? Impossible to please? Perfect. Join 's user panel and

lay it on us.

 

 

[Guest guest]

Under the age of 35 IVF is 50% effective, over 40 it goes down to 10-20%

 

 

 

 

 

 

 

 

-

Chinese Medicine

Friday, September 14, 2007 11:55 PM

Re: A case in point

 

 

whew! just got to the end of this thread. you boys have really been going

at it. David, can i just say, without meaning to put you on the defensive,

relax a little. i know you want to keep the discussion on topic, and not

get personal, but i have noticed through this whole ABORM debate that you

(and others) have tendency to get on the attack. i have felt it.

 

this is a really contentious issue. exploring the ramifications is

important. it gets emotional, because most of us are pretty passionate

about our practice of the medicine and the direction the profession is

going. david raised a strong point about listening and not just trolling

for points to debunk. i think it would be helpful if we (myself

included) could try to hear the others point of view, consider and respond

to that, rather than continuing to push our perspective. i think we've all

staked out our positions really well, so that there is no misunderstanding

about who's on what side of the fence on this. so i'm doubtful any of us

will be successful at 'converting an opponent'. let's keep this

debate friendly and amicable, we're all colleagues.

 

ok, now that that's off my chest, a few points on topic:

 

earlier on hugo made some points about effectiveness of ART.

 

i seem to recall reading some stats about IVF a few months ago on line (not

sure where) showing that it was under 20% effective (i recall a % in the low

teens). does my memory fail? i remember being shocked at this, esp.

considering the high cost of such an ineffective tx. and thinking if our

medicine was that ineffective we'ld never be able to even get a license to

practice, let along open our doors for business. does someone have an

accurate stat on the effectiveness of IVF they could provide? it would also

be interesting to see how much it's increased when acu is added (i recall

that success of IVF increases exponentially).

 

secondly:

 

the debate seems to have strayed from the org topic of certification to the

wider issue of specialization. although linked, i would point out that

these are different issues. (point of clarification). although they are

tied together since we're discussing a certification as a specialist.

 

i think that's part of the problem here, whether passing this test created

by a self appointed board with no oversight qualifies one as a specialist.

(no documentation of coursework or supervised clinical training is

necessary).

 

thirdly:

 

david: you presented a passionate argument about the knowledge of a

reproductive acu. and i see your point as to wanting to distinguish your

depth of knowledge in this field from a generalist, and am contemplating it.

 

a couple of points about this issue:

 

1. i like the term you threw in, reproductive acupuncturist. i might

address this query to mike b: is there any issue against someone like david

(who tx 95% infertility and clearly is accumulating an expertise in the

field), in absence of a $1000 certificate, or a DAOM in infertility, as

noting him/herself as a reproductive acupuncturist? i'm thinking in

marketing materials (since the 'need' for the cert seems to have much to do

with marketing) such as bus cards, website, etc.

2. on the DAOM: mike, i agree, in the future, that is the way to go:

it's legit and provides no doubt of adv. training in the field. but i hear

david, for the present moment, the initial students are beta testers for the

programs. i for one would also not consider enrolling in a DAOM program for

that reason. i also would expect to get a quality of classes from the DAOM

programs that is not yet developed.

3. this leads me back to a point i made early on: we have to accept

that we are pioneers in a developing profession. that means to me that

unfortunately people like david (or Dr. wannabees) don't get the titles yet

because the profession hasn't gotten that far.

4. Ray Rubio made some points who's logic i didn't quite agree with.

he said that when orgs like aaom and nccaom were formed, there weren't other

orgs to oversee them, so a group of practitioner's just got together and

started them, like what ABORM is doing. the difference is (and the flaw

in his logic) is that now we do have other orgs in place, and ABORM has leap

frogged over the proper channels in their (well meaning) haste to get their

$1000 certificate in place. there's a couple of real problems here for me.

 

Firstly, they are starting a precedent for other specialty wannabee's to

follow their models. regardless of whether or not their particular 'board'

is justifiable, it starts a precedent for others. this is truly problematic

since they have not gone through the proper channels to do this, and they

are opening the door for others to follow in their footsteps.

 

secondly, on this issue of going through the NCCA (do i have that one right,

the nat cert commiss?), he said they would get to that down the road. well

i think they are being too hasty about pushing out their product, they

should be working on the NCCA cert now, not as a later afterthought.

 

he said that when they first came up with the idea for ABORM the DAOM

programs weren't started yet. well, first, they knew the programs were on

the way. and second, they are out now, and in fact there is one in

infertility. so why not put their efforts into supporting/developing a

stellar DAOM in infertility rather that their quasi specialty certification

(quasi because it's unapproved by any kind of oversight, doesn't require

coursework or supervised clinical hours)? or put the energy into getting the

channels in place to support development of legitimit specialties.

 

on the issue of clinical training: he says they would work to develop

residencies. a medical specialty includes coursework and clinical

training. they've put the cart before the horse, putting out a specialty

certificate without documentation of coursework or clinical training. they

need to first get the coursework and clinical training in place, then

document it with a specialty. i don't think the argument that right now all

we have is a few ceu classes, a few fertility classes in the colleges and no

clinical training in the field holds water for putting out a specialty that

doesn't document these things. i believe their effort should properly be

goiing into getting these things in place first, and then documenting it

with a certificate or specialty title.

 

while i acknowledge their spunk and tenacity in seeing a problem/need and

rolling up their sleeves and solving it, i don't agree with taking it upon

themselves to put out a specialty certification without working with their

colleagues in the profession to see if others agree that this is the best

solution to the 'problem'.

 

i think this is part of the crux of the opposition to ABORM. that they

did not openly discuss their plans with the acu community, ask for comment,

work with the orgs and the community to see if others in the profession were

on board with their plan, etc. to me, i find it galling that they decided

that they know what's best and implemented it, without any kind of public

comment. they're not an org or a cert. body, they're just a group of people

with a collective body of knowledge in the field. but that doesn't justify

that this small group of [respected] colleagues knows what's best for the

profession and has the best solution for the problem they see. and that

this small group of colleagues implements something that could have huge

ramifications for the profession, without even caring to find out what the

rest of us think should be done or if we agree and want their solution.

 

this is problematic for me on many levels.

 

so what i hear from the repro acu's who support ABORM is that they do so

because they want acknowledgement of their niche practice. there are other

ways to convey this to the west med community and the gen public. but what

the supporters do not seem to get past is the larger ramifications of what

implementing this specialty certification in this manner means to the

profession and practice of tcm in the US.

 

so i think there are 2 major categories of issues here: specialties and

certifications, and the ramifications of what ABORM is doing by implementing

their specialty certification in this matter.

 

lastly: i would like to direct a comment to something david said earlier, in

his argument for a repro acu specialist: that a generalist wouldn't know how

to dx or tx adv or complicated conditions, or when to refer out. i agree

with your train of thought, that there's much a repro acu knows about the

field that a generalist doesn't, however, that doesn't mean that a

generalist doesn't know when to refer out, or, as hugo pointed out, do the

research to figure out how to tx the case. and i think that is a flaw in

your logic.

 

ok guys, be gentle.

 

kb

 

On 9/11/07, Hugo Ramiro <subincor wrote:

>

> Hi David, I really believe that you are reading into my posts, but not

> reading them. That can really be a problem to communication. I hope that we

> can do better in future postings.

>

>

> David Karchmer <acuprof <acuprof%40hotmail.com>>

>

> First of all, IVF is expensive to administer in part because it

>

> takes very expensive technology to perform. A proper IVF facility

>

> can expect a start up cost of between $1-2 million.

>

> Expensive is not synonymous with deceitful or dishonest.

>

> Clearly IVF is an expensive treatment. Add ICSI to the mix and it is

>

> more costly. But, as for who should or should not choose the more

>

> expensive treatment, that is a matter of medical necessity and

>

> personal choice.

>

> Why should we rule out ART on the basis that it is costly?

>

> You said, " I have a particular concern with reproductive

>

> technologies (which are a part of the overall medical organisation,

>

> to be clear). The ethical question I brought up with the mechanic

>

> analogy is the following: if you can do something cheaply, why do it

>

> expensively? "

>

> Am I reading you correctly? Are you suggesting that there is

>

> something underhanded, or malevolant about ART?

>

> You also said, " Further, if there is no evidence to support the use

>

> of an expensive, invasive procedure over the use of a cheaper, non-

>

> invasive procedure, then what should one do? Further, what is the

>

> long-term evidence supporting the use of reproductive technologies?

>

> Where are the studies describing the misuse of reproductive

>

> technologies? "

>

> Just what do you mean by the " evidence supporting ART " or

>

> the " Misuse of ART? "

>

> IVF began as a way to help couples where the female partner had no

>

> functional falopian tubes. It is a way to achieve conception and

>

> carry a baby to term by bypassing missing or damaged tubes.

>

> Furthermore, if the male has no sperm in the ejaculate, sperm can be

>

> obtained by aspirating it through the epididymous or obtained from

>

> testicular tissue via testicular biopsy. At this point, the sperm

>

> obtained can be used to fertilize the egg by way of ICSI.

>

> Are you suggesting that a cheaper method (such as TCM) could be used

>

> instead of IVF in cases of absent oviducts or azoospermia? ?

>

> Really Hugo, I don't think I understand what point you are trying to

>

> make. It just sounds like some kind of Alternative Medicine

>

> conspiracy theory.

>

> Can you clarify?

>

> David Karchmer

>

> Traditional_ Chinese_Medicine , Hugo Ramiro

>

> <subincor@.. .> wrote:

>

> >

>

> > Well David, tit for tat again I suppose. It's a little boring. I

>

> make a comment about mechanics and technological fixes and you think

>

> I shouldn't do that, and are offended(?), and yet you feel free to

>

> hit back with charges of intellectual dishonesty and

>

> irresponsibility (those are pretty serious, ya know). Have your cake

>

> and eat it too? I don't think so, at least not with me.

>

> > So anyway, if we're done with the alpha-male thing, let's move on.

>

> >

>

> > We have seen and documented, over and over, the human activities

>

> of corruption, power-mongering, etc etc. As a profession, we have

>

> seen supposed " scientists " dismiss reasoning, data, and evidence a

>

> priori, repeatedly. Some wiring is on the fritz there. I insist

>

> that intellectual bias as well as financial motivation are a huge

>

> factor in any organisation, and need to be dealt with ethically, as

>

> much as is possible. I have no particular concerns with ABORM over

>

> other organisations. ?I have a particular concern with reproductive

>

> technologies (which are a part of the overall medical organisation,

>

> to be clear). The ethical question I brought up with the mechanic

>

> analogy is the following: if you can do something cheaply, why do it

>

> expensively? Further, if there is no evidence to support the use of

>

> an expensive, invasive procedure over the use of a cheaper, non-

>

> invasive procedure, then what should one do? Further, what is the

>

> long-term evidence supporting the

>

> > use of reproductive technologies? Where are the studies

>

> describing the misuse of reproductive technologies

>

> > Is that clear enough for you? As a side-note, these are not jabs

>

> at you, these are simply restatements of what every single post of

>

> mine has been about. I'd also like to ask, where is the evidence

>

> that supports your point of view that we need certification? That

>

> specialist certification improves patient care and outcome? I am

>

> concerned that the CM profession is simply apeing western medical

>

> procedures and curricula. Don't even get me started on book learning

>

> as currently taught in many medical schools.

>

> > In any case, there is a great deal of controversy on whether to

>

> move forward or study more regarding reproductive technologies, but

>

> it might be interesting to look at ICSI (I don't care if nobody

>

> knows what that means, honestly) and how reproductive scientists

>

> feel about it:

>

> >

>

> > " No hard evidence presented at the moment can prove or disapprove

>

> ICSI's implications in epigenetic control. Nevertheless, we take the

>

> view that more comprehensive, long-term, and properly designed

>

> studies are imperative to be applied on a large-scale basis. We urge

>

> cautiousness, since the welfare of our progeny is what is at stake. "

>

> >

>

> > This is the ethical problem I've posed several times: " Our

>

> progeny are at stake " .

>

> >

>

> > Hugo

>

> >

>

> > ps - the writers are Greek, forgive their English spelling and

>

> grammar. Can be found at:

>

> > http://tinyurl. com/ypc66c

>

> >

>

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[Guest guest]

Dvid T,

 

I can't answer as a simple Yes/No, because I am sure that there are

very experienced and knowledgeable generalists out there.

 

But I will say this; I do not believe that the generalized training

provided by most OM schools prepares an acupuncturist to manage

reproductive cases effectively, nor does the licensing and

certification process involved ensure that an acupuncturist is

knowledgeable in this area.

 

Sorry if that ruffles feathers, but it goes back to my comments

about the ABMS:

 

I don't care if the ABMS claims that all doctors are equally

qualified to see all kinds of cases, if I have a busted leg I would

rather see a doc board certified in orthopedics than an ear, nose

and throat doc.

 

How about you?

 

Hey doc, my leg is shattered! Better break out your otoscope.

 

David K

---

 

 

In

Chinese Medicine , " flyingstarsfengshui "

<flyingstarsfengshui wrote:

>

> David:

>

> Let me try to summarize your view, please let me know if it is

> accurate.

>

> You believe Licensed practitioners are not qualified to practice

RM.

>

> Let us all know.

>

> thanks,

>

> david

>

[Guest guest]

The thread called, " A case in point. "

 

David K

 

 

Chinese Medicine , mike Bowser

<naturaldoc1 wrote:

>

> David,

> And what topic would that be as it seems to be all over the place?

Mike W. Bowser, L Ac

>

>

> : acuprof: Fri, 14 Sep

2007 20:15:23 +0000Re: A case in point

>

>

>

>

> Mike,I think I've made my position pretty clear as it pertains to

your unsolicited advice. Please, do your thing. Do what you do the

way you like to do it - anyway you like to do it. And you can rest

assured that I'll do the same.Anyway, I thought we were discussing

the merits of specialization, not the personalities of those

involved in the discussion. but, since we are expressing personal

preferences, I'll take a shot as well.I'd prefer to keep the thread

on topic.David K.--- In

Chinese Medicine , mike Bowser

<naturaldoc1@> wrote:>> David,> You might not want to display or at

least state things in this way> for future reference. I would also

hope you drop the sarcasm as> that is also very unprofessional. This

has not helped convince us of> your desire but does make one wonder

what is going on. Mike W. Bowser, L Ac> > > To:

Chinese Medicine@: ra6151@: Fri, 14 Sep 2007 12:12:02 -

0400Re: A case in point> > > > > I couldn't agree

more, Andrea Beth.--RoseAnne, L.Ac.

<@>@:

Fri, 14 Sep 2007 07:43:51 -0700 (PDT)Re: A case in

pointOh, please...! Do I need to point out how offensive this

comment is? And howit alone can entirely topple the image of

professionalism all your previousposts have attempted to build?

Sheesh!David Karchmer <acuprof@> wrote:I'm

just a vocal guywith a box of needles who knows his way around a

vagina.Boardwalk for $500? In 2007?

Ha!Play Monopoly Here and Now (it's updated for today's economy) at

Games.

[Guest guest]

Kath,

 

Thanks for bringing some level-headedness to this HotTopic.

I'll try to be nice. : )

 

David K (Pacifist, Humanitarian and lover of Kittens)

 

 

Chinese Medicine , " Kath Bartlett,

MS, LAc " wrote:

>

> whew! just got to the end of this thread. you boys have really

been going

> at it. David, can i just say, without meaning to put you on the

defensive,

> relax a little. i know you want to keep the discussion on topic,

and not

> get personal, but i have noticed through this whole ABORM debate

that you

> (and others) have tendency to get on the attack. i have felt it.

>

> this is a really contentious issue. exploring the ramifications is

> important. it gets emotional, because most of us are pretty

passionate

> about our practice of the medicine and the direction the

profession is

> going. david raised a strong point about listening and not just

trolling

> for points to debunk. i think it would be helpful if we (myself

> included) could try to hear the others point of view, consider and

respond

> to that, rather than continuing to push our perspective. i think

we've all

> staked out our positions really well, so that there is no

misunderstanding

> about who's on what side of the fence on this. so i'm doubtful

any of us

> will be successful at 'converting an opponent'. let's keep this

> debate friendly and amicable, we're all colleagues.

>

> ok, now that that's off my chest, a few points on topic:

>

> earlier on hugo made some points about effectiveness of ART.

>

> i seem to recall reading some stats about IVF a few months ago on

line (not

> sure where) showing that it was under 20% effective (i recall a %

in the low

> teens). does my memory fail? i remember being shocked at this,

esp.

> considering the high cost of such an ineffective tx. and thinking

if our

> medicine was that ineffective we'ld never be able to even get a

license to

> practice, let along open our doors for business. does someone

have an

> accurate stat on the effectiveness of IVF they could provide? it

would also

> be interesting to see how much it's increased when acu is added (i

recall

> that success of IVF increases exponentially).

>

> secondly:

>

> the debate seems to have strayed from the org topic of

certification to the

> wider issue of specialization. although linked, i would point out

that

> these are different issues. (point of clarification). although

they are

> tied together since we're discussing a certification as a

specialist.

>

> i think that's part of the problem here, whether passing this test

created

> by a self appointed board with no oversight qualifies one as a

specialist.

> (no documentation of coursework or supervised clinical training is

> necessary).

>

>

> thirdly:

>

> david: you presented a passionate argument about the knowledge of

a

> reproductive acu. and i see your point as to wanting to

distinguish your

> depth of knowledge in this field from a generalist, and am

contemplating it.

>

>

> a couple of points about this issue:

>

>

> 1. i like the term you threw in, reproductive acupuncturist. i

might

> address this query to mike b: is there any issue against

someone like david

> (who tx 95% infertility and clearly is accumulating an

expertise in the

> field), in absence of a $1000 certificate, or a DAOM in

infertility, as

> noting him/herself as a reproductive acupuncturist? i'm

thinking in

> marketing materials (since the 'need' for the cert seems to

have much to do

> with marketing) such as bus cards, website, etc.

> 2. on the DAOM: mike, i agree, in the future, that is the way

to go:

> it's legit and provides no doubt of adv. training in the

field. but i hear

> david, for the present moment, the initial students are beta

testers for the

> programs. i for one would also not consider enrolling in a

DAOM program for

> that reason. i also would expect to get a quality of classes

from the DAOM

> programs that is not yet developed.

> 3. this leads me back to a point i made early on: we have to

accept

> that we are pioneers in a developing profession. that means to

me that

> unfortunately people like david (or Dr. wannabees) don't get

the titles yet

> because the profession hasn't gotten that far.

> 4. Ray Rubio made some points who's logic i didn't quite agree

with.

> he said that when orgs like aaom and nccaom were formed, there

weren't other

> orgs to oversee them, so a group of practitioner's just got

together and

> started them, like what ABORM is doing. the difference is (and

the flaw

> in his logic) is that now we do have other orgs in place, and

ABORM has leap

> frogged over the proper channels in their (well meaning) haste

to get their

> $1000 certificate in place. there's a couple of real problems

here for me.

>

>

> Firstly, they are starting a precedent for other specialty

wannabee's to

> follow their models. regardless of whether or not their

particular 'board'

> is justifiable, it starts a precedent for others. this is truly

problematic

> since they have not gone through the proper channels to do this,

and they

> are opening the door for others to follow in their footsteps.

>

> secondly, on this issue of going through the NCCA (do i have that

one right,

> the nat cert commiss?), he said they would get to that down the

road. well

> i think they are being too hasty about pushing out their product,

they

> should be working on the NCCA cert now, not as a later

afterthought.

>

> he said that when they first came up with the idea for ABORM the

DAOM

> programs weren't started yet. well, first, they knew the programs

were on

> the way. and second, they are out now, and in fact there is one in

> infertility. so why not put their efforts into

supporting/developing a

> stellar DAOM in infertility rather that their quasi specialty

certification

> (quasi because it's unapproved by any kind of oversight, doesn't

require

> coursework or supervised clinical hours)? or put the energy into

getting the

> channels in place to support development of legitimit specialties.

>

> on the issue of clinical training: he says they would work to

develop

> residencies. a medical specialty includes coursework and clinical

> training. they've put the cart before the horse, putting out a

specialty

> certificate without documentation of coursework or clinical

training. they

> need to first get the coursework and clinical training in place,

then

> document it with a specialty. i don't think the argument that

right now all

> we have is a few ceu classes, a few fertility classes in the

colleges and no

> clinical training in the field holds water for putting out a

specialty that

> doesn't document these things. i believe their effort should

properly be

> goiing into getting these things in place first, and then

documenting it

> with a certificate or specialty title.

>

> while i acknowledge their spunk and tenacity in seeing a

problem/need and

> rolling up their sleeves and solving it, i don't agree with taking

it upon

> themselves to put out a specialty certification without working

with their

> colleagues in the profession to see if others agree that this is

the best

> solution to the 'problem'.

>

> i think this is part of the crux of the opposition to ABORM. that

they

> did not openly discuss their plans with the acu community, ask for

comment,

> work with the orgs and the community to see if others in the

profession were

> on board with their plan, etc. to me, i find it galling that they

decided

> that they know what's best and implemented it, without any kind of

public

> comment. they're not an org or a cert. body, they're just a group

of people

> with a collective body of knowledge in the field. but that

doesn't justify

> that this small group of [respected] colleagues knows what's best

for the

> profession and has the best solution for the problem they see.

and that

> this small group of colleagues implements something that could

have huge

> ramifications for the profession, without even caring to find out

what the

> rest of us think should be done or if we agree and want their

solution.

>

> this is problematic for me on many levels.

>

> so what i hear from the repro acu's who support ABORM is that they

do so

> because they want acknowledgement of their niche practice. there

are other

> ways to convey this to the west med community and the gen public.

but what

> the supporters do not seem to get past is the larger ramifications

of what

> implementing this specialty certification in this manner means to

the

> profession and practice of tcm in the US.

>

> so i think there are 2 major categories of issues here:

specialties and

> certifications, and the ramifications of what ABORM is doing by

implementing

> their specialty certification in this matter.

>

> lastly: i would like to direct a comment to something david said

earlier, in

> his argument for a repro acu specialist: that a generalist

wouldn't know how

> to dx or tx adv or complicated conditions, or when to refer out.

i agree

> with your train of thought, that there's much a repro acu knows

about the

> field that a generalist doesn't, however, that doesn't mean that a

> generalist doesn't know when to refer out, or, as hugo pointed

out, do the

> research to figure out how to tx the case. and i think that is a

flaw in

> your logic.

>

> ok guys, be gentle.

>

> kb

[Guest guest]

We will just have to (civally, thanks to Kath) agree to disagree on

this one. My opinion is based on two formative experiences:

 

1) The fact that the longer I specialize in one area, and the more I

learn about reproductive medicine, the more I realize how much I

didn't know about it before.

 

2) The great number of patients who come to me after having seen

other acupuncturists who did not inquire about many of the things

that I believe are basic to reproductive acupuncture.

 

David K.

 

--- In

Chinese Medicine , " flyingstarsfengshui "

<flyingstarsfengshui wrote:

>

> Hi David:

>

> It my opinion it is normal for practioners to continue their

education

> in all areas of medicine after graduation, whether one treats

> diabetics or post stroke patients or infertilty, this is a normal

> process.

>

> Your orthopedics vs Ear, Nose and Throat physician is not apples

to

> apples, not a good analogy, IMHO. A better one would be whether

you

> would see your general practioner for diabetes treatment or a

> specialist in endocrinology.

>

> I think if ABORM or its supporters believe licensed practioners

are

> not qualified to treat infertility patients they should take this

> issue up directly with state and national licensing boards or

> organizations. In this way we can get the licensing agencies to

> present their opinions on the matter and any legal value of a

> certificate.

>

> Regards,

>

> david

>

[Guest guest]

civilly - Sorry. (Geez, is that right? How DO you spell that word?!?)

 

 

Chinese Medicine , " David

Karchmer " <acuprof wrote:

>

> We will just have to (civally, thanks to Kath) agree to disagree

on

> this one. My opinion is based on two formative experiences:

>

> 1) The fact that the longer I specialize in one area, and the more

I

> learn about reproductive medicine, the more I realize how much I

> didn't know about it before.

>

> 2) The great number of patients who come to me after having seen

> other acupuncturists who did not inquire about many of the things

> that I believe are basic to reproductive acupuncture.

>

> David K.

>

> --- In

>

Chinese Medicine , " flyingstarsfengshui "

> <flyingstarsfengshui@> wrote:

> >

> > Hi David:

> >

> > It my opinion it is normal for practioners to continue their

> education

> > in all areas of medicine after graduation, whether one treats

> > diabetics or post stroke patients or infertilty, this is a

normal

> > process.

> >

> > Your orthopedics vs Ear, Nose and Throat physician is not apples

> to

> > apples, not a good analogy, IMHO. A better one would be whether

> you

> > would see your general practioner for diabetes treatment or a

> > specialist in endocrinology.

> >

> > I think if ABORM or its supporters believe licensed practioners

> are

> > not qualified to treat infertility patients they should take

this

> > issue up directly with state and national licensing boards or

> > organizations. In this way we can get the licensing agencies to

> > present their opinions on the matter and any legal value of a

> > certificate.

> >

> > Regards,

> >

> > david

> >

>

[Guest guest]

sincerely.

-David Lesseps

 

On Sep 15, 2007, at 1:22 PM, David Karchmer wrote:

 

> civilly - Sorry. (Geez, is that right? How DO you spell that word?!?)

>

> Chinese Medicine , " David

> Karchmer " <acuprof wrote:

> >

> > We will just have to (civally, thanks to Kath) agree to disagree

> on

> > this one. My opinion is based on two formative experiences:

> >

> > 1) The fact that the longer I specialize in one area, and the more

> I

> > learn about reproductive medicine, the more I realize how much I

> > didn't know about it before.

> >

> > 2) The great number of patients who come to me after having seen

> > other acupuncturists who did not inquire about many of the things

> > that I believe are basic to reproductive acupuncture.

> >

> > David K.

> >

> > --- In

> >

> Chinese Medicine , " flyingstarsfengshui "

> > <flyingstarsfengshui@> wrote:

> > >

> > > Hi David:

> > >

> > > It my opinion it is normal for practioners to continue their

> > education

> > > in all areas of medicine after graduation, whether one treats

> > > diabetics or post stroke patients or infertilty, this is a

> normal

> > > process.

> > >

> > > Your orthopedics vs Ear, Nose and Throat physician is not apples

> > to

> > > apples, not a good analogy, IMHO. A better one would be whether

> > you

> > > would see your general practioner for diabetes treatment or a

> > > specialist in endocrinology.

> > >

> > > I think if ABORM or its supporters believe licensed practioners

> > are

> > > not qualified to treat infertility patients they should take

> this

> > > issue up directly with state and national licensing boards or

> > > organizations. In this way we can get the licensing agencies to

> > > present their opinions on the matter and any legal value of a

> > > certificate.

> > >

> > > Regards,

> > >

> > > david

> > >

> >

>

>

>

 

 

[Guest guest]

Kath,

In response to your query about " reproductive acupuncturist " and marketing.

I would say usage of a title is directly determined by your state acupuncture

statutes. Many states use LAc after a person's name but that does not allow

one to change or to add any other word(s) to it. I would think that this usage

would not be tolerated and could subject the LAc to unethical conduct by the

licensing board. He can certainly say that his focus is on fertility or that he

only treats these types of cases.

 

As for the DAOM, there have been several graduating classes that have stated

that they learned a lot and recommend the advanced training. Not sure where

you are getting your info. Choose the program wisely and talk it over with

current students. BTW, many students have had issue with their masters

programs as well and yet if you had not taken the leap you would not be here.

 

All these programs are on a learning curve and some are better then others.Mike

W. Bowser, L Ac

 

 

: acuprof:

Sat, 15 Sep 2007 18:32:28 +0000Re: A case in point

 

 

 

 

Kath,Thanks for bringing some level-headedness to this HotTopic.I'll try to be

nice. : )David K (Pacifist, Humanitarian and lover of Kittens)--- In

Chinese Medicine , " "

wrote:>> whew! just got to the end of this thread. you boys have

really been going> at it. David, can i just say, without meaning to put you on

the defensive,> relax a little. i know you want to keep the discussion on topic,

and not> get personal, but i have noticed through this whole ABORM debate that

you> (and others) have tendency to get on the attack. i have felt it.> > this is

a really contentious issue. exploring the ramifications is> important. it gets

emotional, because most of us are pretty passionate> about our practice of the

medicine and the direction the profession is> going. david raised a strong point

about listening and not just trolling> for points to debunk. i think it would be

helpful if we (myself> included) could try to hear the others point of view,

consider and respond> to that, rather than continuing to push our perspective. i

think we've all> staked out our positions really well, so that there is no

misunderstanding> about who's on what side of the fence on this. so i'm doubtful

any of us> will be successful at 'converting an opponent'. let's keep this>

debate friendly and amicable, we're all colleagues.> > ok, now that that's off

my chest, a few points on topic:> > earlier on hugo made some points about

effectiveness of ART.> > i seem to recall reading some stats about IVF a few

months ago on line (not> sure where) showing that it was under 20% effective (i

recall a % in the low> teens). does my memory fail? i remember being shocked at

this, esp.> considering the high cost of such an ineffective tx. and thinking if

our> medicine was that ineffective we'ld never be able to even get a license to>

practice, let along open our doors for business. does someone have an> accurate

stat on the effectiveness of IVF they could provide? it would also> be

interesting to see how much it's increased when acu is added (i recall> that

success of IVF increases exponentially).> > secondly:> > the debate seems to

have strayed from the org topic of certification to the> wider issue of

specialization. although linked, i would point out that> these are different

issues. (point of clarification). although they are> tied together since we're

discussing a certification as a specialist.> > i think that's part of the

problem here, whether passing this test created> by a self appointed board with

no oversight qualifies one as a specialist.> (no documentation of coursework or

supervised clinical training is> necessary).> > > thirdly:> > david: you

presented a passionate argument about the knowledge of a> reproductive acu. and

i see your point as to wanting to distinguish your> depth of knowledge in this

field from a generalist, and am contemplating it.> > > a couple of points about

this issue:> > > 1. i like the term you threw in, reproductive acupuncturist. i

might> address this query to mike b: is there any issue against someone like

david> (who tx 95% infertility and clearly is accumulating an expertise in the>

field), in absence of a $1000 certificate, or a DAOM in infertility, as> noting

him/herself as a reproductive acupuncturist? i'm thinking in> marketing

materials (since the 'need' for the cert seems to have much to do> with

marketing) such as bus cards, website, etc.> 2. on the DAOM: mike, i agree, in

the future, that is the way to go:> it's legit and provides no doubt of adv.

training in the field. but i hear> david, for the present moment, the initial

students are beta testers for the> programs. i for one would also not consider

enrolling in a DAOM program for> that reason. i also would expect to get a

quality of classes from the DAOM> programs that is not yet developed.> 3. this

leads me back to a point i made early on: we have to accept> that we are

pioneers in a developing profession. that means to me that> unfortunately people

like david (or Dr. wannabees) don't get the titles yet> because the profession

hasn't gotten that far.> 4. Ray Rubio made some points who's logic i didn't

quite agree with.> he said that when orgs like aaom and nccaom were formed,

there weren't other> orgs to oversee them, so a group of practitioner's just got

together and> started them, like what ABORM is doing. the difference is (and the

flaw> in his logic) is that now we do have other orgs in place, and ABORM has

leap> frogged over the proper channels in their (well meaning) haste to get

their> $1000 certificate in place. there's a couple of real problems here for

me.> > > Firstly, they are starting a precedent for other specialty wannabee's

to> follow their models. regardless of whether or not their particular 'board'>

is justifiable, it starts a precedent for others. this is truly problematic>

since they have not gone through the proper channels to do this, and they> are

opening the door for others to follow in their footsteps.> > secondly, on this

issue of going through the NCCA (do i have that one right,> the nat cert

commiss?), he said they would get to that down the road. well> i think they are

being too hasty about pushing out their product, they> should be working on the

NCCA cert now, not as a later afterthought.> > he said that when they first came

up with the idea for ABORM the DAOM> programs weren't started yet. well, first,

they knew the programs were on> the way. and second, they are out now, and in

fact there is one in> infertility. so why not put their efforts into

supporting/developing a> stellar DAOM in infertility rather that their quasi

specialty certification> (quasi because it's unapproved by any kind of

oversight, doesn't require> coursework or supervised clinical hours)? or put the

energy into getting the> channels in place to support development of legitimit

specialties.> > on the issue of clinical training: he says they would work to

develop> residencies. a medical specialty includes coursework and clinical>

training. they've put the cart before the horse, putting out a specialty>

certificate without documentation of coursework or clinical training. they> need

to first get the coursework and clinical training in place, then> document it

with a specialty. i don't think the argument that right now all> we have is a

few ceu classes, a few fertility classes in the colleges and no> clinical

training in the field holds water for putting out a specialty that> doesn't

document these things. i believe their effort should properly be> goiing into

getting these things in place first, and then documenting it> with a certificate

or specialty title.> > while i acknowledge their spunk and tenacity in seeing a

problem/need and> rolling up their sleeves and solving it, i don't agree with

taking it upon> themselves to put out a specialty certification without working

with their> colleagues in the profession to see if others agree that this is the

best> solution to the 'problem'.> > i think this is part of the crux of the

opposition to ABORM. that they> did not openly discuss their plans with the acu

community, ask for comment,> work with the orgs and the community to see if

others in the profession were> on board with their plan, etc. to me, i find it

galling that they decided> that they know what's best and implemented it,

without any kind of public> comment. they're not an org or a cert. body, they're

just a group of people> with a collective body of knowledge in the field. but

that doesn't justify> that this small group of [respected] colleagues knows

what's best for the> profession and has the best solution for the problem they

see. and that> this small group of colleagues implements something that could

have huge> ramifications for the profession, without even caring to find out

what the> rest of us think should be done or if we agree and want their

solution.> > this is problematic for me on many levels.> > so what i hear from

the repro acu's who support ABORM is that they do so> because they want

acknowledgement of their niche practice. there are other> ways to convey this to

the west med community and the gen public. but what> the supporters do not seem

to get past is the larger ramifications of what> implementing this specialty

certification in this manner means to the> profession and practice of tcm in the

US.> > so i think there are 2 major categories of issues here: specialties and>

certifications, and the ramifications of what ABORM is doing by implementing>

their specialty certification in this matter.> > lastly: i would like to direct

a comment to something david said earlier, in> his argument for a repro acu

specialist: that a generalist wouldn't know how> to dx or tx adv or complicated

conditions, or when to refer out. i agree> with your train of thought, that

there's much a repro acu knows about the> field that a generalist doesn't,

however, that doesn't mean that a> generalist doesn't know when to refer out,

or, as hugo pointed out, do the> research to figure out how to tx the case. and

i think that is a flaw in> your logic.> > ok guys, be gentle.> > kb

 

 

 

 

 

 

_______________

Gear up for Halo® 3 with free downloads and an exclusive offer. It’s our way of

saying thanks for using Windows Live™.

http://gethalo3gear.com?ocid=SeptemberWLHalo3_WLHMTxt_2

 

 

[Guest guest]

David,

We have and continue to debate the so-called merits and problems

with the ABORM and more globally the unaccredited certification

programs at large. My question to you is why are you interested

in going backward with our profession when we have worked so

hard to get where we are? Please keep in mind that there is

nothing stopping you from taking any seminar and learning more

about fertility.

 

Thanks Kath for your wonderful post. Mike W. Bowser, L Ac

 

 

: acuprof:

Sat, 15 Sep 2007 18:29:14 +0000Re: A case in point

 

 

 

 

The thread called, " A case in point. " David K--- In

Chinese Medicine , mike Bowser <naturaldoc1

wrote:>> David,> And what topic would that be as it seems to be all over the

place?Mike W. Bowser, L Ac> > > :

acuprof: Fri, 14 Sep 2007 20:15:23 +0000Re: A case in point>

> > > > Mike,I think I've made my position pretty clear as it pertains to your

unsolicited advice. Please, do your thing. Do what you do the way you like to do

it - anyway you like to do it. And you can rest assured that I'll do the

same.Anyway, I thought we were discussing the merits of specialization, not the

personalities of those involved in the discussion. but, since we are expressing

personal preferences, I'll take a shot as well.I'd prefer to keep the thread on

topic.David K.Chinese Medicine , mike Bowser

<naturaldoc1@> wrote:>> David,> You might not want to display or at least state

things in this way> for future reference. I would also hope you drop the sarcasm

as> that is also very unprofessional. This has not helped convince us of> your

desire but does make one wonder what is going on. Mike W. Bowser, L Ac> > > To:

Chinese Medicine@: ra6151@: Fri, 14 Sep 2007 12:12:02 -0400Subject:

Re: A case in point> > > > > I couldn't agree more, Andrea

Beth.--RoseAnne, L.Ac.

<@>@: Fri, 14 Sep 2007 07:43:51 -0700

(PDT)Re: A case in pointOh, please...! Do I need to point out how

offensive this comment is? And howit alone can entirely topple the image of

professionalism all your previousposts have attempted to build? Sheesh!Andrea

Beth Damsky, L.Ac.David Karchmer <acuprof@> wrote:I'm just a vocal guywith a box

of needles who knows his way around a

vagina.Boardwalk for $500? In 2007? Ha!Play

Monopoly Here and Now (it's updated for today's economy) at

Games.

[Guest guest]

At some point we won't be able to treat anything if it comes down

to the idea of specialization as a pre-req. School preps you to see

and treat a number of conditions yet we also look for ways to refer

to others who are more knowledgeable. These may also be generalists

who have more years. The danger with too much focus is that you

can miss the forest for the trees. I have noticed this from time to

time as patients should have been seen by another allopath who was

unable or not correctly able to diagnose the problem. No or little

communication between specialties. We should be careful to avoid

this issue.Mike W. Bowser, L Ac

 

 

 

 

 

 

 

 

_______________

Can you find the hidden words?  Take a break and play Seekadoo!

http://club.live.com/seekadoo.aspx?icid=seek_wlmailtextlink

 

 

[Guest guest]

thank you to mike, andrea and david for your positive feedback about

my recent post. it means a lot.

 

k

 

 

On 9/15/07, mike Bowser <naturaldoc1 wrote:

>

> At some point we won't be able to treat anything if it comes down

> to the idea of specialization as a pre-req. School preps you to see

> and treat a number of conditions yet we also look for ways to refer

> to others who are more knowledgeable. These may also be generalists

> who have more years. The danger with too much focus is that you

> can miss the forest for the trees. I have noticed this from time to

> time as patients should have been seen by another allopath who was

> unable or not correctly able to diagnose the problem. No or little

> communication between specialties. We should be careful to avoid

> this issue.Mike W. Bowser, L Ac

>

> ________

> Can you find the hidden words? Take a break and play Seekadoo!

> http://club.live.com/seekadoo.aspx?icid=seek_wlmailtextlink

>

>

[Guest guest]

" why are you interested in going backward with our profession when

we have worked so hard to get where we are? "

 

************************************************************

What a curious question. I'm not interested whatsoever in " going

backward with our profession. " Whatever would give you that

impression?

 

David K.

 

 

 

 

 

 

Chinese Medicine , mike Bowser

<naturaldoc1 wrote:

>

> David,

> We have and continue to debate the so-called merits and problems

> with the ABORM and more globally the unaccredited certification

> programs at large. My question to you is why are you interested

> in going backward with our profession when we have worked so

> hard to get where we are? Please keep in mind that there is

> nothing stopping you from taking any seminar and learning more

> about fertility.

>

> Thanks Kath for your wonderful post. Mike W. Bowser, L Ac

>

>

> : acuprof: Sat, 15 Sep

2007 18:29:14 +0000Re: A case in point

>

>

>

>

> The thread called, " A case in point. " David K--- In

Chinese Medicine , mike Bowser

<naturaldoc1@> wrote:>> David,> And what topic would that be as it

seems to be all over the place?Mike W. Bowser, L Ac> > > To:

Chinese Medicine@: acuprof@: Fri, 14 Sep 2007 20:15:23

+0000Re: A case in point> > > > > Mike,I think I've

made my position pretty clear as it pertains to your unsolicited

advice. Please, do your thing. Do what you do the way you like to do

it - anyway you like to do it. And you can rest assured that I'll do

the same.Anyway, I thought we were discussing the merits of

specialization, not the personalities of those involved in the

discussion. but, since we are expressing personal preferences, I'll

take a shot as well.I'd prefer to keep the thread on topic.David K.--

- In Chinese Medicine , mike Bowser

<naturaldoc1@> wrote:>> David,> You might not want to display or at

least state things in this way> for future reference. I would also

hope you drop the sarcasm as> that is also very unprofessional. This

has not helped convince us of> your desire but does make one wonder

what is going on. Mike W. Bowser, L Ac> > > To:

Chinese Medicine@: ra6151@: Fri, 14 Sep 2007 12:12:02 -

0400Re: A case in point> > > > > I couldn't agree

more, Andrea Beth.--RoseAnne, L.Ac.

<@>@:

Fri, 14 Sep 2007 07:43:51 -0700 (PDT)Re: A case in

pointOh, please...! Do I need to point out how offensive this

comment is? And howit alone can entirely topple the image of

professionalism all your previousposts have attempted to build?

Sheesh!David Karchmer <acuprof@> wrote:I'm

just a vocal guywith a box of needles who knows his way around a

vagina.Boardwalk for $500? In 2007?

Ha!Play Monopoly Here and Now (it's updated for today's economy) at

Games.

[Guest guest]

That is what you are proposing with unaccredited programs. Mike W. Bowser, L Ac

 

 

: acuprof:

Sun, 16 Sep 2007 03:37:53 +0000Re: A case in point

 

 

 

 

" why are you interested in going backward with our profession when we have

worked so hard to get where we

are? " ************************************************************What a curious

question. I'm not interested whatsoever in " going backward with our profession. "

Whatever would give you that impression?David K.--- In

Chinese Medicine , mike Bowser <naturaldoc1

wrote:>> David,> We have and continue to debate the so-called merits and

problems> with the ABORM and more globally the unaccredited certification >

programs at large. My question to you is why are you interested> in going

backward with our profession when we have worked so> hard to get where we are?

Please keep in mind that there is > nothing stopping you from taking any seminar

and learning more > about fertility. > > Thanks Kath for your wonderful post.

Mike W. Bowser, L Ac> > > : acuprof:

Sat, 15 Sep 2007 18:29:14 +0000Re: A case in point> > > > > The

thread called, " A case in point. " David K--- In

Chinese Medicine , mike Bowser <naturaldoc1@>

wrote:>> David,> And what topic would that be as it seems to be all over the

place?Mike W. Bowser, L Ac> > > @: acuprof@:

Fri, 14 Sep 2007 20:15:23 +0000Re: A case in point> > > > >

Mike,I think I've made my position pretty clear as it pertains to your

unsolicited advice. Please, do your thing. Do what you do the way you like to do

it - anyway you like to do it. And you can rest assured that I'll do the

same.Anyway, I thought we were discussing the merits of specialization, not the

personalities of those involved in the discussion. but, since we are expressing

personal preferences, I'll take a shot as well.I'd prefer to keep the thread on

topic.David K.Chinese Medicine , mike Bowser

<naturaldoc1@> wrote:>> David,> You might not want to display or at least state

things in this way> for future reference. I would also hope you drop the sarcasm

as> that is also very unprofessional. This has not helped convince us of> your

desire but does make one wonder what is going on. Mike W. Bowser, L Ac> > > To:

Chinese Medicine@: ra6151@: Fri, 14 Sep 2007 12:12:02 -0400Subject:

Re: A case in point> > > > > I couldn't agree more, Andrea

Beth.--RoseAnne, L.Ac.

<@>@: Fri, 14 Sep 2007 07:43:51 -0700

(PDT)Re: A case in pointOh, please...! Do I need to point out how

offensive this comment is? And howit alone can entirely topple the image of

professionalism all your previousposts have attempted to build? Sheesh!Andrea

Beth Damsky, L.Ac.David Karchmer <acuprof@> wrote:I'm just a vocal guywith a box

of needles who knows his way around a

vagina.Boardwalk for $500? In 2007? Ha!Play

Monopoly Here and Now (it's updated for today's economy) at

Games.

[Guest guest]

With Donor egg, it is closer to 80%.

 

David K

 

 

Chinese Medicine , " Alon Marcus "

<alonmarcus wrote:

>

> Under the age of 35 IVF is 50% effective, over 40 it goes down to 10-

20%

>

>

>

>

>

>

>

>

[Guest guest]

thanks alon.

 

k

 

 

On 9/15/07, Alon Marcus <alonmarcus wrote:

>

> Under the age of 35 IVF is 50% effective, over 40 it goes down to 10-20%

>

>

>

>

>

>

>

>

> -

>

> To:

Chinese Medicine <Chinese Medicine%40yaho\

ogroups.com>

> Friday, September 14, 2007 11:55 PM

> Re: A case in point

>

> whew! just got to the end of this thread. you boys have really been going

> at it. David, can i just say, without meaning to put you on the defensive,

> relax a little. i know you want to keep the discussion on topic, and not

> get personal, but i have noticed through this whole ABORM debate that you

> (and others) have tendency to get on the attack. i have felt it.

>

> this is a really contentious issue. exploring the ramifications is

> important. it gets emotional, because most of us are pretty passionate

> about our practice of the medicine and the direction the profession is

> going. david raised a strong point about listening and not just trolling

> for points to debunk. i think it would be helpful if we (myself

> included) could try to hear the others point of view, consider and respond

> to that, rather than continuing to push our perspective. i think we've all

> staked out our positions really well, so that there is no misunderstanding

> about who's on what side of the fence on this. so i'm doubtful any of us

> will be successful at 'converting an opponent'. let's keep this

> debate friendly and amicable, we're all colleagues.

>

> ok, now that that's off my chest, a few points on topic:

>

> earlier on hugo made some points about effectiveness of ART.

>

> i seem to recall reading some stats about IVF a few months ago on line

> (not

> sure where) showing that it was under 20% effective (i recall a % in the

> low

> teens). does my memory fail? i remember being shocked at this, esp.

> considering the high cost of such an ineffective tx. and thinking if our

> medicine was that ineffective we'ld never be able to even get a license to

> practice, let along open our doors for business. does someone have an

> accurate stat on the effectiveness of IVF they could provide? it would

> also

> be interesting to see how much it's increased when acu is added (i recall

> that success of IVF increases exponentially).

>

> secondly:

>

> the debate seems to have strayed from the org topic of certification to

> the

> wider issue of specialization. although linked, i would point out that

> these are different issues. (point of clarification). although they are

> tied together since we're discussing a certification as a specialist.

>

> i think that's part of the problem here, whether passing this test created

> by a self appointed board with no oversight qualifies one as a specialist.

> (no documentation of coursework or supervised clinical training is

> necessary).

>

> thirdly:

>

> david: you presented a passionate argument about the knowledge of a

> reproductive acu. and i see your point as to wanting to distinguish your

> depth of knowledge in this field from a generalist, and am contemplating

> it.

>

> a couple of points about this issue:

>

> 1. i like the term you threw in, reproductive acupuncturist. i might

> address this query to mike b: is there any issue against someone like

> david

> (who tx 95% infertility and clearly is accumulating an expertise in the

> field), in absence of a $1000 certificate, or a DAOM in infertility, as

> noting him/herself as a reproductive acupuncturist? i'm thinking in

> marketing materials (since the 'need' for the cert seems to have much to

> do

> with marketing) such as bus cards, website, etc.

> 2. on the DAOM: mike, i agree, in the future, that is the way to go:

> it's legit and provides no doubt of adv. training in the field. but i hear

> david, for the present moment, the initial students are beta testers for

> the

> programs. i for one would also not consider enrolling in a DAOM program

> for

> that reason. i also would expect to get a quality of classes from the DAOM

> programs that is not yet developed.

> 3. this leads me back to a point i made early on: we have to accept

> that we are pioneers in a developing profession. that means to me that

> unfortunately people like david (or Dr. wannabees) don't get the titles

> yet

> because the profession hasn't gotten that far.

> 4. Ray Rubio made some points who's logic i didn't quite agree with.

> he said that when orgs like aaom and nccaom were formed, there weren't

> other

> orgs to oversee them, so a group of practitioner's just got together and

> started them, like what ABORM is doing. the difference is (and the flaw

> in his logic) is that now we do have other orgs in place, and ABORM has

> leap

> frogged over the proper channels in their (well meaning) haste to get

> their

> $1000 certificate in place. there's a couple of real problems here for me.

>

> Firstly, they are starting a precedent for other specialty wannabee's to

> follow their models. regardless of whether or not their particular 'board'

> is justifiable, it starts a precedent for others. this is truly

> problematic

> since they have not gone through the proper channels to do this, and they

> are opening the door for others to follow in their footsteps.

>

> secondly, on this issue of going through the NCCA (do i have that one

> right,

> the nat cert commiss?), he said they would get to that down the road. well

> i think they are being too hasty about pushing out their product, they

> should be working on the NCCA cert now, not as a later afterthought.

>

> he said that when they first came up with the idea for ABORM the DAOM

> programs weren't started yet. well, first, they knew the programs were on

> the way. and second, they are out now, and in fact there is one in

> infertility. so why not put their efforts into supporting/developing a

> stellar DAOM in infertility rather that their quasi specialty

> certification

> (quasi because it's unapproved by any kind of oversight, doesn't require

> coursework or supervised clinical hours)? or put the energy into getting

> the

> channels in place to support development of legitimit specialties.

>

> on the issue of clinical training: he says they would work to develop

> residencies. a medical specialty includes coursework and clinical

> training. they've put the cart before the horse, putting out a specialty

> certificate without documentation of coursework or clinical training. they

> need to first get the coursework and clinical training in place, then

> document it with a specialty. i don't think the argument that right now

> all

> we have is a few ceu classes, a few fertility classes in the colleges and

> no

> clinical training in the field holds water for putting out a specialty

> that

> doesn't document these things. i believe their effort should properly be

> goiing into getting these things in place first, and then documenting it

> with a certificate or specialty title.

>

> while i acknowledge their spunk and tenacity in seeing a problem/need and

> rolling up their sleeves and solving it, i don't agree with taking it upon

> themselves to put out a specialty certification without working with their

> colleagues in the profession to see if others agree that this is the best

> solution to the 'problem'.

>

> i think this is part of the crux of the opposition to ABORM. that they

> did not openly discuss their plans with the acu community, ask for

> comment,

> work with the orgs and the community to see if others in the profession

> were

> on board with their plan, etc. to me, i find it galling that they decided

> that they know what's best and implemented it, without any kind of public

> comment. they're not an org or a cert. body, they're just a group of

> people

> with a collective body of knowledge in the field. but that doesn't justify

> that this small group of [respected] colleagues knows what's best for the

> profession and has the best solution for the problem they see. and that

> this small group of colleagues implements something that could have huge

> ramifications for the profession, without even caring to find out what the

> rest of us think should be done or if we agree and want their solution.

>

> this is problematic for me on many levels.

>

> so what i hear from the repro acu's who support ABORM is that they do so

> because they want acknowledgement of their niche practice. there are other

> ways to convey this to the west med community and the gen public. but what

> the supporters do not seem to get past is the larger ramifications of what

> implementing this specialty certification in this manner means to the

> profession and practice of tcm in the US.

>

> so i think there are 2 major categories of issues here: specialties and

> certifications, and the ramifications of what ABORM is doing by

> implementing

> their specialty certification in this matter.

>

> lastly: i would like to direct a comment to something david said earlier,

> in

> his argument for a repro acu specialist: that a generalist wouldn't know

> how

> to dx or tx adv or complicated conditions, or when to refer out. i agree

> with your train of thought, that there's much a repro acu knows about the

> field that a generalist doesn't, however, that doesn't mean that a

> generalist doesn't know when to refer out, or, as hugo pointed out, do the

> research to figure out how to tx the case. and i think that is a flaw in

> your logic.

>

> ok guys, be gentle.

>

> kb

>

> On 9/11/07, Hugo Ramiro <subincor <subincor%40>> wrote:

> >

> > Hi David, I really believe that you are reading into my posts, but not

> > reading them. That can really be a problem to communication. I hope that

> we

> > can do better in future postings.

> >

> >

> > David Karchmer <acuprof

<acuprof%40hotmail.com><acuprof%40hotmail.com>>

> >

> > First of all, IVF is expensive to administer in part because it

> >

> > takes very expensive technology to perform. A proper IVF facility

> >

> > can expect a start up cost of between $1-2 million.

> >

> > Expensive is not synonymous with deceitful or dishonest.

> >

> > Clearly IVF is an expensive treatment. Add ICSI to the mix and it is

> >

> > more costly. But, as for who should or should not choose the more

> >

> > expensive treatment, that is a matter of medical necessity and

> >

> > personal choice.

> >

> > Why should we rule out ART on the basis that it is costly?

> >

> > You said, " I have a particular concern with reproductive

> >

> > technologies (which are a part of the overall medical organisation,

> >

> > to be clear). The ethical question I brought up with the mechanic

> >

> > analogy is the following: if you can do something cheaply, why do it

> >

> > expensively? "

> >

> > Am I reading you correctly? Are you suggesting that there is

> >

> > something underhanded, or malevolant about ART?

> >

> > You also said, " Further, if there is no evidence to support the use

> >

> > of an expensive, invasive procedure over the use of a cheaper, non-

> >

> > invasive procedure, then what should one do? Further, what is the

> >

> > long-term evidence supporting the use of reproductive technologies?

> >

> > Where are the studies describing the misuse of reproductive

> >

> > technologies? "

> >

> > Just what do you mean by the " evidence supporting ART " or

> >

> > the " Misuse of ART? "

> >

> > IVF began as a way to help couples where the female partner had no

> >

> > functional falopian tubes. It is a way to achieve conception and

> >

> > carry a baby to term by bypassing missing or damaged tubes.

> >

> > Furthermore, if the male has no sperm in the ejaculate, sperm can be

> >

> > obtained by aspirating it through the epididymous or obtained from

> >

> > testicular tissue via testicular biopsy. At this point, the sperm

> >

> > obtained can be used to fertilize the egg by way of ICSI.

> >

> > Are you suggesting that a cheaper method (such as TCM) could be used

> >

> > instead of IVF in cases of absent oviducts or azoospermia? ?

> >

> > Really Hugo, I don't think I understand what point you are trying to

> >

> > make. It just sounds like some kind of Alternative Medicine

> >

> > conspiracy theory.

> >

> > Can you clarify?

> >

> > David Karchmer

> >

> > Traditional_ Chinese_Medicine , Hugo Ramiro

> >

> > <subincor@.. .> wrote:

> >

> > >

> >

> > > Well David, tit for tat again I suppose. It's a little boring. I

> >

> > make a comment about mechanics and technological fixes and you think

> >

> > I shouldn't do that, and are offended(?), and yet you feel free to

> >

> > hit back with charges of intellectual dishonesty and

> >

> > irresponsibility (those are pretty serious, ya know). Have your cake

> >

> > and eat it too? I don't think so, at least not with me.

> >

> > > So anyway, if we're done with the alpha-male thing, let's move on.

> >

> > >

> >

> > > We have seen and documented, over and over, the human activities

> >

> > of corruption, power-mongering, etc etc. As a profession, we have

> >

> > seen supposed " scientists " dismiss reasoning, data, and evidence a

> >

> > priori, repeatedly. Some wiring is on the fritz there. I insist

> >

> > that intellectual bias as well as financial motivation are a huge

> >

> > factor in any organisation, and need to be dealt with ethically, as

> >

> > much as is possible. I have no particular concerns with ABORM over

> >

> > other organisations. ?I have a particular concern with reproductive

> >

> > technologies (which are a part of the overall medical organisation,

> >

> > to be clear). The ethical question I brought up with the mechanic

> >

> > analogy is the following: if you can do something cheaply, why do it

> >

> > expensively? Further, if there is no evidence to support the use of

> >

> > an expensive, invasive procedure over the use of a cheaper, non-

> >

> > invasive procedure, then what should one do? Further, what is the

> >

> > long-term evidence supporting the

> >

> > > use of reproductive technologies? Where are the studies

> >

> > describing the misuse of reproductive technologies

> >

> > > Is that clear enough for you? As a side-note, these are not jabs

> >

> > at you, these are simply restatements of what every single post of

> >

> > mine has been about. I'd also like to ask, where is the evidence

> >

> > that supports your point of view that we need certification? That

> >

> > specialist certification improves patient care and outcome? I am

> >

> > concerned that the CM profession is simply apeing western medical

> >

> > procedures and curricula. Don't even get me started on book learning

> >

> > as currently taught in many medical schools.

> >

> > > In any case, there is a great deal of controversy on whether to

> >

> > move forward or study more regarding reproductive technologies, but

> >

> > it might be interesting to look at ICSI (I don't care if nobody

> >

> > knows what that means, honestly) and how reproductive scientists

> >

> > feel about it:

> >

> > >

> >

> > > " No hard evidence presented at the moment can prove or disapprove

> >

> > ICSI's implications in epigenetic control. Nevertheless, we take the

> >

> > view that more comprehensive, long-term, and properly designed

> >

> > studies are imperative to be applied on a large-scale basis. We urge

> >

> > cautiousness, since the welfare of our progeny is what is at stake. "

> >

> > >

> >

> > > This is the ethical problem I've posed several times: " Our

> >

> > progeny are at stake " .

> >

> > >

> >

> > > Hugo

> >

> > >

> >

> > > ps - the writers are Greek, forgive their English spelling and

> >

> > grammar. Can be found at:

> >

> > > http://tinyurl. com/ypc66c

> >

> > >

> >

> > <!--

> >

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> > list-style-type:none;clear:both;border:1px solid #e0ecee;

> > }

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> >

>

font-weight:bold;color:#ff7900;float:right;width:2em;text-align:right;padding-ri\

ght:.5em;}

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> > font-weight:bold;}

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> > text-decoration:none;}

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> > padding:6px 13px;background-color:#e0ecee;margin-bottom:20px;}

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> > list-style-type:square;padding:6px 0;font-size:77%;}

> > #ygrp-sponsor #ov li a{

> > text-decoration:none;font-size:130%;}

> > #ygrp-sponsor #nc{

> > background-color:#eee;margin-bottom:20px;padding:0 8px;}

> > #ygrp-sponsor .ad{

> > padding:8px 0;}

> > #ygrp-sponsor .ad #hd1{

> >

>

font-family:Arial;font-weight:bold;color:#628c2a;font-size:100%;line-height:122%\

;}

> >

> > #ygrp-sponsor .ad a{

> > text-decoration:none;}

> > #ygrp-sponsor .ad a:hover{

> > text-decoration:underline;}

> > #ygrp-sponsor .ad p{

> > margin:0;}

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> > #ygrp-text tt{

> > font-size:120%;}

> > blockquote{margin:0 0 0 4px;}

> > .replbq{margin:4;}

> > -->

> >

> > ________

> > Want ideas for reducing your carbon footprint? Visit For Good

> > http://uk.promotions./forgood/environment.html

> >

> >

[Guest guest]

Please cite your sources for these figures. Mike W. Bowser, L Ac

 

 

: acuprof:

Sun, 16 Sep 2007 12:30:36 +0000Re: A case in point

 

 

 

 

With Donor egg, it is closer to 80%.David K--- In

Chinese Medicine , " Alon Marcus " <alonmarcus

wrote:>> Under the age of 35 IVF is 50% effective, over 40 it goes down to

10-20%> > > > > > >

>

 

 

 

 

 

 

_______________

Can you find the hidden words?  Take a break and play Seekadoo!

http://club.live.com/seekadoo.aspx?icid=seek_wlmailtextlink

 

 

[Guest guest]

Mike,

 

All reprouctive endocrinologists are required by law to report their

statitics to the CDC. Here is the weblink where they publish the

data:

 

http://www.cdc.gov/ART/ART2004/download.htm

 

David K

 

Chinese Medicine , mike Bowser

<naturaldoc1 wrote:

>

> Please cite your sources for these figures. Mike W. Bowser, L Ac

>

>

> : acuprof: Sun, 16 Sep

2007 12:30:36 +0000Re: A case in point

>

>

>

>

> With Donor egg, it is closer to 80%.David K--- In

Chinese Medicine , " Alon Marcus "

<alonmarcus@> wrote:>> Under the age of 35 IVF is 50% effective,

over 40 it goes down to 10-20%> > > > 400 29th St.

#419> > > >

_______________

> Can you find the hidden words?  Take a break and play Seekadoo!

> http://club.live.com/seekadoo.aspx?icid=seek_wlmailtextlink

>

>

[Guest guest]

Thats a useful link. tks.

 

On 9/17/07, David Karchmer <acuprof wrote:

>

> Mike,

>

> All reprouctive endocrinologists are required by law to report their

> statitics to the CDC. Here is the weblink where they publish the

> data:

>

> http://www.cdc.gov/ART/ART2004/download.htm

>

> David K

>

> --- In

Chinese Medicine <Chinese Medicine%40yaho\

ogroups.com>,

> mike Bowser

> <naturaldoc1 wrote:

> >

> > Please cite your sources for these figures. Mike W. Bowser, L Ac

> >

> >

> > : acuprof: Sun, 16 Sep

> 2007 12:30:36 +0000Re: A case in point

> >

> >

> >

> >

> > With Donor egg, it is closer to 80%.David K--- In

>

Chinese Medicine <Chinese Medicine%40yaho\

ogroups.com>,

> " Alon Marcus "

> <alonmarcus@> wrote:>> Under the age of 35 IVF is 50% effective,

> over 40 it goes down to 10-20%> > > > 400 29th St.

> #419> > > >

> >

> >

> >

> >

> >

> >

> > ________

> > Can you find the hidden words? Take a break and play Seekadoo!

> > http://club.live.com/seekadoo.aspx?icid=seek_wlmailtextlink

> >

> >

[Guest guest]

" Why fixate on something as trivial as a bawdy comment injected to lighten the

tone? "

 

Because it was trivial to you, David, but not necessarily other people. You

need to look past the tip of your own nose. I am truly surprised at your lack of

sense.

 

David, I do not appreciate such a combative and ungiving attitude from someone

who is in the health profession. I personally am tired of your deviousness

(accusing me of trolling instead of simply attending to the points I made). I

feel that you are probably the only one who has /not/ understood my posts. To

understand and communicate is different from coming to an agreement. You

definitely crossed the line for me with your comment about your expertness

around " vaginas " . You obviously need to be the big man (da4 nan2 ren2), and as

such, you may have the last word. I am also surprised at your seeming height for

someone who has merely 10 years of experience. In a forum which hosts many 20+

years of experience practitioners, I would have thought you'd force yourself to

behave with more decorum. Medicine is a subtle practice; not something one uses

blunt instruments on.

Of course this discussion wasn't a total loss and I wish you well, but I am out

of this one.

Goodbye,

Hugo

 

 

" Troll and Troll by is he that setteth naught by no man, nor no man by him. This

is he that would bear rule in a place and hath no authority nor thanks, and at

last is thrust out of the door like a knave. "

 

further, from wiki:

" Attributing intent to trolls is a very difficult issue since by its very nature

to call someone a troll is to already assume an intent, that they are posting

only to cause problems. So once a person is called a troll they have already

been categorized by the speaker as someone with a certain intention.

 

Many people call others trolls, few call themselves trolls, [...] "

 

 

 

 

 

David Karchmer <acuprof

Chinese Medicine

Thursday, 13 September, 2007 7:56:34 AM

Re: A case in point

 

 

 

 

 

 

 

 

 

 

 

 

 

Hugo,

 

 

 

Are you familiar with the internet term, Troll?

 

 

 

I can post the definition if you like.

 

 

 

David K

 

 

 

Traditional_ Chinese_Medicine , Hugo Ramiro

 

<subincor@.. .> wrote:

 

>

 

> Hi David, the point was simply that you asserted that " personal

 

philosophies " had no place in a " medical " or " health " setting for

 

you, when in fact, they do have a central place for you. If you like

 

I can copy and paste the relevant passages from your messages.

 

> I think we all agree that we bring our philosophies to practice.

 

>

 

> Hugo

 

>

 

>

 

> David Karchmer <acuprof >

 

>

 

> Wednesday, 12 September, 2007 8:16:26 PM

 

> Re: A case in point

 

>

 

>

 

>

 

>

 

>

 

>

 

>

 

>

 

>

 

>

 

>

 

>

 

>

 

> Hugo,

 

>

 

>

 

>

 

> Two things to say.

 

>

 

>

 

>

 

> 1) I think I laid out my philosophy pretty succinctly in my

 

response

 

>

 

> to Mike.

 

>

 

>

 

>

 

> If people want to have children and there is no discernable medical

 

>

 

> reason why they should not, I try to help them get what they most

 

>

 

> want. If there is a medical risk, I try to learn as much as I can

 

so

 

>

 

> that I can best educate them about what potential risks are

 

involved.

 

>

 

>

 

>

 

> I use the principles of to help my patients to

 

>

 

> become as healthy as possible so that their chances of natural

 

>

 

> conception increase (if they choose to try to conceive naturally),

 

>

 

> and their chances of having a successful outcome with ART improve

 

>

 

> (if they choose to use ART procedures).

 

>

 

>

 

>

 

> The goal of my clinic is healthy full term pregnancies resulting in

 

>

 

> live births. This is achieved through the application of TCM in

 

>

 

> order to optimize health, thereby maximizing outcomes.

 

>

 

>

 

>

 

> Period.

 

>

 

>

 

>

 

> 2) I am not a Taoist priest, a philosopher or a shaman. I am not an

 

>

 

> ethicist, a clergyman or a sage. To quote DeForest Kelley, " Dammit

 

>

 

> Jim, I'm just a country doctor! "

 

>

 

>

 

>

 

> My purpose is to help people to optimize physiological function so

 

>

 

> that they are able to conceive, maintain a healthy pregnancy, carry

 

>

 

> their baby(s) to term, have a healthy post-partum recovery, and

 

have

 

>

 

> the family for which they have longed.

 

>

 

>

 

>

 

> Although I am not sure why it is integral or particularly relevant

 

>

 

> to the conversations at hand, that is my philosophy. I hope that

 

>

 

> helps, somehow.

 

>

 

>

 

>

 

> David K

 

>

 

>

 

>

 

> Traditional_ Chinese_Medicine , Hugo Ramiro

 

>

 

> <subincor@ .> wrote:

 

>

 

> >

 

>

 

> > Hi David. I don't see that you responded to Mike's concerns.

 

>

 

> > Mike wrote:

 

>

 

> > " As ethics is guided by philosophy, I am deeply concerned about

 

>

 

> this attitude and what I am hearing. "

 

>

 

> >

 

>

 

> > Hugo

 

>

 

>

 

>

 

>

 

>

 

>

 

>

 

>

 

>

 

>

 

>

 

>

 

>

 

>

 

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> -->

 

>

 

>

 

>

 

>

 

>

 

>

 

>

 

>

 

> ____________ _________ _________ _________ _________ _________ _

 

> Want ideas for reducing your carbon footprint? Visit For

 

Good http://uk.promotion s./ forgood/environm ent.html

 

>

 

>