There has been a new proposal for an additional tier of licensure for acupuncturists in New Mexico, LAc’s, which would include “acupuncture and adjunct therapies but not Chinese herbal medicine.”

Reportedly, NM Representative Christine Chandler has been favorably hearing the proposal, and DOMs may well want to weigh in approval or disapproval of such a new license, along with supporting educational discussion of their individual views. We want NM DOMs to have a heads up about this, because there well may be ramifications or unintended consequences if we have LAc’s along with our current DOM’s in the future.

To follow is a well laid-out letter to Representative Christine Chandler that Dr. Caterina Di Palma, DOM, NMSAAM Board Member at Large, has been working up as her answer to the proposal for the LAc license for several of us to sign when and if we are ready.

We, the New Mexico Society for Acupuncture and Asian Medicine, NMSAAM, our NM state professional organization, allied with our national professional organization American Society for Acupuncturists, appreciate your willingness to make acupuncture and Oriental medicine services more accessible and affordable throughout NM.

We can all agree that all New Mexicans, particularly those in remote rural locations, pueblos and reservations need greater access to all health care services including what some call CAM, Complementary Alternative Medicine, such as Acupuncture and Oriental medicine, Chiropractic, etc.

We are in the process of discussions with NM DOMs about this, and now this blog will start disseminating information to all NM DOMs. So far, the DOMs that the Legislative Committee has communicated with strongly disagree with the proposal put forth by Eleni Fredlund and Claire Bartlett.  Moreover, it will threaten the work our Doctors of Oriental Medicine are continuing to do to increase accessibility and affordability to all of our treatments.

What is the answer to providing Oriental Medicine services, including Acupuncture, Community Acupuncture, and Acudetox to all people in NM, no matter how remotely they live from services?

• Pass the Health Security Act.
• Acupuncture & Oriental Medicine need to be recognized and offered as part of Medicare, Medicaid, Public Health and Indian Health services offered in NM.
• Allow Doctors of Oriental Medicine to make a salary as employees or contract workers of NM DOH, Public Health, and IHS.
• DOMs are best to offer these services, because of their training, experience in diagnosis and have many more modalities that can be adjusted to provide treatment to individual people with different needs.
• These treatments can be delivered in a “Community” setting, people sitting in a circle, being treated at the same time, or in an addiction treatment program, or private treatment as necessary.  All DOMs are capable of delivering treatment in all of these settings.
• Offer DOMs a chance to work off their student loans by working in remote rural locations, reservations, pueblos for public health, IHS, etc.
• Offer scholarships to acupuncture and Oriental medicine colleges to residents living in remote rural communities, reservations and pueblos with a proviso that they return to their area to provide treatment for a specific number of years.  They will have to be paid a decent living by the agency that employs them like IHS, DOH, and NM Public Health.

This is the work we DOMS and our allies need to promote in the NM legislature and nationally.  This may be the longer, more difficult road home, but it is the correct solution to create greater, affordable access to acupuncture and Oriental Medicine, a medicine that helps people become whole, instead of replacing DOMs with providers with a lower level of education, experience and practice.

People from other healthcare professions now seek to introduce a new tier of “acupuncture and adjunct therapies” to the Acupuncture and Oriental Medicine Practice Act.  They proclaim that will make acupuncture more accessible to rural areas, pueblos and reservations, AND more affordable.

How will this new tier of practitioners provide more accessible and affordable healthcare to New Mexicans in rural areas, pueblos and reservations?

• Will the practitioners only work in remote rural areas and reservations?
• Will these practitioners NOT be concentrated in urban areas?  However, most of them live in or near urban centers.
• Will there be any restrictions on where this new tier of practitioners will be allowed to practice?
• Will it be more affordable, how, why?
• Will they be restricted to only providing “Community” acupuncture?
• Will they be restricted from setting up private practices?
• What “adjunct therapies” will they be allowed to provide?
• Will there be restrictions to this new level of practitioner from having private practices in urban areas?
• Will there be restrictions on what they can charge for their services?
• Will they be able to be included on health insurance company panels and receive payment from insurance companies?

Because Acupuncture and Oriental Medicine has not been allowed to provide services in the mainstream medical system, many DOMs are unable to support themselves.  They do not have enough work and are forced to leave the profession.

ON TIERED PRACTICE:

This new level of practice is not significantly different from the services that DOMs provide, so why create another tier?

Nurses, counselors, etc. have many tiers of practice because they have many significantly different specialties, they have many opportunities, and there are many jobs for them to fill.

Essentially, L.Ac’s would be providing the same treatments to their patients that we do. However, we have no lack of DOMs to cover the whole state of NM; we have a lack of opportunities for us to practice our medicine.  Until DOMs in NM have more opportunities and more patients than they can handle, we see no reason to add another tier of practice to our Scope of Practice.

Some of the NM people asking for this change knew before enrolling in a school that did not offer herb training that this was a requirement to practice acupuncture in NM.  Instead they decided to become acupuncturists through changing our Scope of Practice Act.

The increases in standards, requirements for Acupuncture & Oriental Medicine practice were implemented for the protection of New Mexicans and to provide greater efficacy and results of the treatments they receive.

Should we offer a less complete medicine to poorer people in rural areas?

All professions, EMTs, Counseling & Therapy, MDs, PTs, etc., as they develop, increase the introductory level of education necessary to become licensed.  All Acupuncture & Oriental Medicine colleges have increased the requirements and number of credits for graduation over the years.

In NM, the increased standards for Licensed Acupuncturists to have the title of DOMs were made to increase the effectiveness of our treatments, and give us increased opportunities, possible opportunities for work within healthcare systems and reimbursement from health insurance companies.

The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) has increased the requirements for testing, certification and continuing education as well.

The restrictions to practice acupuncture in NM are not a result of discrimination to prevent more practitioners.

The restrictions are more a consequence of what healthcare services and practitioners are recognized by the federal & state government, public health systems, and insurance. Health insurance companies have closed and/or limited their panels of acupuncture providers. The co pays and deductibles for those who have insurance are so high that they are barriers to treatment. For DOMS, if you are not a provider for health insurance companies and have a private treatment practice, it is almost impossible to make a living.

Many health care practitioners: MDs, PAs, Therapists, Counselors, Physical Therapists, etc. want to practice acupuncture because they know it works, often better than their techniques.  The answer is not to add another tier to the Acupuncture and Oriental Medicine Scope of Practice Act or to increase their scopes of practice, but to employ DOMs in their facilities, programs, and public health to deliver the fullest and best treatments possible to people who are in pain, suffering and in need of care.

We DOMs are inspired by the efficacy of the entirety of the medicine we studied, continue to study, and increase our skills that we would like to offer widely to alleviate the health problems and pain we see everywhere.

Respectfully,

Dr. Caterina Di Palma, DOM
NMSAAM Board Member at Large

Please submit your comments to info@nmsaam.org. We want to hear from NMDOMs!

If you prefer to go directly to the NM Representative who has reportedly been favorably hearing Eleni Fredlund and Claire Bartlett ‘s proposal:
State Representative Christine Chandler
1208 9th Street
Los Alamos, NM 87544
christine.chandler@nmlegis.gov

Please note:
This article expresses the opinions and research of the author, and does not necessarily reflect all views or policies of NMSAAM members, the NMSAAM BOD, or the ASA.