I am writing to express my concern over the use of the title "doctor" in your publication. As you are aware, there are only a few programs and courses of study that are presently accredited to offer the title "doctor," and there are no graduates from any of these programs yet.
I have noticed that your publication tends to use the word "doctor" after articles, (but) does not clarify the field in which some of your PhDs hold their doctorates - leading one to assume they hold an advanced degree in Oriental medicine, when that is not the case. In addition, on your Web site, a number of columnists who were listed in your publication as "LAc" had "doctor" added to their biographies.
Blurring credentials and creating inconsistencies does not serve to raise the standards of our profession, or create unity or integrity. Because of this, I was wary of your publication and of the columnists who allowed this kind of distortion to occur from the first time I happened to glance at your paper. How could I trust the information contained in any of your articles if credentials are expanded inappropriately?
The article I read that day, in the October 2000 issue by Marilyn Allen, was entitled, "Why We Call You Doctor." The rationale Ms. Allen puts forth might be a dictionary definition of "doctor," but it is at odds with the term as it is used legally and how it is commonly thought of, especially by patients and policymakers. I'm surprised that Ms. Allen, who teaches ethics, would encourage this. Misrepresenting education, training and credentials is considered to be a serious ethical lapse. Disclaimers on your masthead notwithstanding, by publishing Ms. Allen's article (who is the editor), you have declared your editorial bias, and I believe you have an obligation to our profession to redress the confusion this trend has engendered.
In order to preserve the integrity and credibility of our profession, as well as the future of the doctoral degree programs newly in place and still emerging, I respectfully request that you create a policy that accurately reflects the training and education of your columnists for both your Web site and publication. I am also bringing this issue to the NCCAOM, CCAOM and ACAOM for their review. I await your timely response.
Elizabeth Call, MS, LAc Greenwich, New York
The managing editor responds:
We appreciate Ms. Call bringing her concern regarding the use of the "Doctor" title to our attention. I agree with her that in most states, acupuncturists can't use the "Doctor" title. Should she (or any other interested reader) get the chance, though, I would suggest picking up a copy of the latest version of Acupuncture and Oriental Medicine Laws, published by the National Acupuncture Foundation. One would be just as surprised as I was to find out which titles acupuncturists can (and can't) use.
Most people consider the "LAc" designation the universally accepted sign for licensed acupuncturist. In fact, only 25 states specifically allow use of the "LAc" designation or some derivation of it. In the other 25 states and the District of Columbia, licensing laws either don't exist, or acupuncturists are legally called something else.
In Rhode Island and New Mexico, for example, acupuncturists may use the "Dr." title. In Florida, they can use the term "acupuncture physician" - but according to Webster's New College Dictionary, a "physician" is the equivalent of a medical doctor.
In West Virginia, an acupuncturist can use the title "Doctor" if he or she earns a doctoral degree in acupuncture, Oriental medicine, a biological science, or a related discipline, from an accredited educational institution. However, if the degree isn't from an accredited school of medicine, the "doctor" has to explain that he or she isn't a Western medical physician.
In Hawaii, a person can use the "Dr." or "DAc" designation provided that person either earns a doctoral degree from a recognized, accredited university, or completes an acupuncture program approved by the state acupuncture board and meets certain standards for the use of academic designations developed by the board.
Five states use the term "certified acupuncturist" or "registered acupuncturist" instead of LAc. Another seven states and the District of Columbia simply use "acupuncturist." In a handful of states, the laws don't specify whether the doctoral title can be used. And in other states, like Wisconsin, there are no laws regarding to the use of titles: licensees may simply use any initials or titles for which they have credentials.
This brings us to an important question: Was our decision to call people "Doctor," even when they weren't entitled to the designation, unethical, as suggested in the above letter? In my opinion, no - and I'll explain why.
Looking at it from the perspective of late 2003, with an actual doctoral degree program for acupuncturists in place and flourishing, it does seem spurious to call a person "Doctor" when he or she clearly is not. Had we only recently chosen to address acupuncturists as "Doctor," I would agree with Ms. Call's assertions wholeheartedly.
However, one must remember that our decision to call acupuncturists "doctor" was made long before the Accreditation Commission for Acupuncture and Oriental Medicine unveiled its accreditation standards for clinical doctoral programs, and nearly two years before any school received approval to begin an accredited doctoral program. Based on the time our decision was announced, along with the myriad designations acupuncturists are currently allowed to use, I don't see how we could be considered unethical, much less have an "editorial bias," for doing so.
As of press time, the NCCAOM hasn't sent us any correspondence regarding Ms. Call's letter. Neither has the CCAOM, ACAOM, or any state or national acupuncture association. In fact, from the time Marilyn Allen's article was published some three years ago up to now, only one other acupuncturist has written or called to complain about Acupuncture Today's "doctor" policy.1 This suggests that the vast majority of the profession either (a.) doesn't know about our policy; (b.) knows about it, but doesn't think it's that important an issue; or (c.) has accepted our decision as is.
That said, and given the developments that have occurred in the profession in the past few years, we are taking Ms. Call's letter as a signal that it's time to make some changes to the way the information in our publication (and on our Web site) is presented. Over the past month, we have updated the biographies of the columnists on AcupunctureToday.com to read "Mr." or "Ms." where appropriate, and are in the process of reviewing each archived article on AcupunctureToday.com to remove any inappropriate doctoral references. We expect to have these revisions completed by the end of the year. We have also taken steps to ensure that the proper titles are used for all of our contributors in all future issues of Acupuncture Today.
To our readers, please be assured that our decision to use the "Dr." title was never intended to mislead or offend our readers; it was simply our way of paying respect to those who comprise the acupuncture and Oriental medicine profession. If we've caused anyone any harm in the process, we apologize, and if there's anything else we can do to improve our publication, please don't hesitate to contact Marilyn or myself.
Michael Devitt Managing Editor
"A Matter of Degrees." Acupuncture Today, September 2003.
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