Minnesota Judge Allows Use of Acupuncture Exam Developed by National Board of Chiropractic Examiners
By Sara Larson
After weeks of contentious testimony submitted by licensed acupuncturists and the Minnesota Board of Chiropractic Examiners (MBCE), Judge Beverly Heydinger ruled on March 26 that the MBCE could go ahead with its plans to require chiropractors to pass a controversial examination developed by the National Board of Chiropractic Examiners (NBCE).
The examination consists of 200 multiple choice questions on acupunctural subject matter. Passage of the examination, together with proof of 100 hours of unspecified acupuncture education, will be required of all chiropractors who wish to utilize acupuncture in their practices in Minnesota.
Opponents have claimed that the rule will allow chiropractors to advertise themselves as "board certified" in acupuncture. "This was an opportunity missed by the judge and the MBCE to improve something that needs clarification," said Mark McKenzie, LAc, academic dean of the Minnesota College of Acupuncture and Oriental Medicine (MCAOM). "We're disappointed that the judge didn't rule our way, but the MBCE is legally entitled to propose such a ruling."
Judge Heydinger ruled that the MBCE has the statutory authority to propose such a rule, determined a need for it, and demonstrated that the proposed rule is "reasonable." In her ruling, however, she pointed out that her decision in this matter should not be interpreted as a determination that the proposed rule was the best approach to assure competency in acupuncture practice. "Generally, it is not the proper role of the administrative law judge to determine which policy alternative presents the 'best' approach since this would invade the policy-making discretion of the agency," wrote Judge Heydinger. "The question is, rather, whether the choice made by the agency is one that a rational person could have made."
Speaking after the ruling, John Pirog, LAc, author of Practical Application of Meridian Style Acupuncture and one of the acupuncturists offering testimony at the hearing, argued that the NBCE board certification process was a disservice to both professions. "It's not just LAcs that are affected by this rule. If you are a chiropractor and you have gone through the trouble of fulfilling NCCAOM's training requirements, you no longer have a clear credential to distinguish yourself from colleagues who have only 100 hours of training. From now on, every DC registering under this rule will be calling himself 'board certified.'"
In his written testimony to the court, Larry Spicer, DC, executive director of the MBCE, argued that such public perceptions were not "relevant to the instant matter" of the proposed rule, but added that "...it is conceivable that members of the public may become savvy enough to distinguish between chiropractors who have been registered subsequent to examination and those who have not. As a practical matter, the board believes that any such member ... will also be able to distinguish between a chiropractor who is merely using acupuncture in conjunction with care, as opposed to a licensed acupuncturist."
The proposed rule does nothing to change the amount of acupuncture training required of chiropractors, which was set at 100 hours in 1992. It is this training that appeared to be at the root of objections raised by the acupuncture profession. In testimony submitted to the judge, Dean McKenzie wrote that "neither competence nor protection of the public can be achieved by inclusion of an exam based on an outdated standard of 100 hours of training." Pirog claimed that no examination, even that of the NCCAOM, could ensure competency unless preceded by proper training. "Our central objection to this rule is that it uses a multiple choice test to disguise inadequate acupuncture education," he said. "And that is not in the interest of the public."
Others feel that the crux of the debate is over scope of practice. Under Minnesota law, chiropractors may practice acupuncture only as a preparatory or complementary procedure to adjustments. However, it is unclear how this differs from the use of acupuncture as an independent therapy. "If there are Chiropractors who want to use acupuncture to return chiropractic to the days when they treated somatovisceral problems, they need more training," commented Leah Olson, a first-year acupuncture student at MCAOM. "It's not the 100 hours per se, it's what they might think they're qualified to do after 100 hours."
Sarah Larson is the Legislative Committee Chairperson of the Acupuncture and Oriental Medicine Students of the Midwest, an advocacy group for acupuncture students. She is currently a freshman at the Minnesota College of Acupuncture and Oriental Medicine at Northwestern Health Sciences University.