When the AAAOM first formed in 2007, their mission was clear: to support the profession through education, resources and legislative advocacy.
The first years of the organization were filled with promise and hope. There were more than 40 state associations on board and members were gearing up to move the profession full speed ahead. But, somewhere along the way, the waters got murky.
In the last four years, the organization went from high praise to dwindling membership (more than 50 percent in four years), a recent exodus of board members, dwindling finances (a more than 60 percent drop in revenue) and the decline in support from numerous state associations who will not be renewing their membership this year.
Today, the current leadership of the organization has been asked to provide answers for both its members and the profession – who deserve not only transparency – but also a credible explanation for the perilous and steady decline of an organization once filled with so much promise.
The "Mass Exodus"
One area both current leaders and former board members seem to agree on, is that many of the AAAOM's issues stem from a lack of cohesiveness and a common vision. The recurring theme in the past few years has been, "the lack of trust, lack of transparency, overall governance issues and imaging issues."
One of the biggest exodus of members occurred within the last year, with board member resignations from Kimberly Benjamin, Daerr Reid, Jennifer Minor, Mori West and Executive Director Denise Graham, who originally came to the organization in April 2013 to help turn things around.
(Update: Since the publishing of this story, board member Dr. Cynthia Clark has also resigned from her post effective February 21)
According to Michael Jabbour, AAAOM President since 2011, the primary reason for the resignations is that the people involved had a "difference in opinion in terms of what the future of AAAOM should be and the majority of the board was not in favor of the proposed direction and those directors were simply not able to move forward with us."
In addressing the exit of the recent Executive Director Denise Graham, Jabbour said the exit had to do with a differing of opinions on the current top priorities: legislation and a unified competency model.
"I think every organization wrestles with the challenges that are before it and the leadership that are before it and I think that sometimes there can be contention around what is the top priority and how resources are utilized on that priority, so we were not able to reconcile our vision on what was our top priority and how resources should be spent on that priority," said Jabbour.
On the same day Jabbour was interviewed for this article, Graham reportedly received a "cease and desist" letter from the AAAOM warning her against talking to anyone regarding the organization.
In her resignation letter to colleagues, former Board member Daerr Reid noted, "Most recently, Denise Graham, a person with an impeccable reputation in the non-profit community has resigned as our Executive Director. In her short time with AAAOM, she formed invaluable relationships with allied professions, which now leaves not only our profession, but others questioning what is wrong with AAAOM. There are many specific reasons why so many loyal, capable volunteers and friends of our profession now refuse to work with the current leadership."
The growing disappointment has been well documented. Resignation letters to colleagues note a number of reasons for the recent departures ranging from concern to clear frustration with the handling of everything from finances to legislation.
"Unfortunately, over the past year, I experienced an increasingly uncomfortable and controlled board environment coupled with a lack of healthy discussion and collaboration among board members limiting the ability to move projects forward," wrote Jennifer Minor in her resignation letter.
In Kimberly Benjamin's resignation letter, she also noted that, "the association developed and continued to engage in negative patterns that they are unwilling to accept and so I find myself unable to support. Instead, the continual practice of dismissing any/all who do not agree with our current leadership led to the mass exodus of board members who grew frustrated with dysfunctional practices. Pertinent information designed to assist the board with its decision-making did not always find its way to board members. Nor was community feedback pertaining to the AAAOM made known in too many instances."
These sentiments are also echoed in comments from recorded interviews with inside sources who spoke exclusively with Acupuncture Today.
"There was one person controlling the message to the board and the message going to the community," said a source who wished to remain anonymous due to fear of retribution. "When I began to question things, it became an argument a lot of the times."
Others noted that Jabbour often used "bullying" tactics to control the board and displayed a "lack of professionalism" when it came to sharing ideas and being open to new solutions.
"Accountability was a big issue," said another source who also requested anonymity. "We had a responsibility to the members and you want other people keeping you accountable, in every position you want accountability because it's a lot for one person to take on all of that responsibility. It's good for people to function and ask questions in that manner, and that is not the way this was functioning."
The mass exodus did not end with board members. Daerr Reid noted in her resignation letter that, "The AAAOM has lost 50% of their membership and revenue since 2009."
Through phone calls with various state associations that are members of AAAOM, Acupuncture Today estimates as many as 20 of the 41 state association members may not be renewing their membership with the organization this year. This is in sharp contrast to Jabbour's interview comments that "there has been a significant increase in state association members."
Should the AAAOM lose that many organizational members, it would further reduce the organization's revenue an additional $9,000, not to mention losses of individual members that are also members of the state associations withdrawing their support.
Jennifer Stone, the Editor-in-Chief of the American Acupuncturist, AAAOM's quarterly journal, has also decided not to renew her contract with AAAOM because she said she feels that, "within the current environment of AAAOM" she is "unable to do her job effectively."
Stone told Acupuncture Today in a written statement that she has been; "restricted from attending board meetings, has been unable to communicate with other AOM organizations and has been unable to form alliances and business relationships."
(Update: Associate editor Lynn Eder also resigned from her contracted position with AAAOM effective February 19)
A Tale of Two Presidents
Michael JabbourJoshua Saul
Since the resignation of Executive Director Denise Graham, AAAOM has had two presidents; Michael Jabbour, the President since 2011 and Joshua Saul, who was appointed as "Acting President" in November of last year and who is expected to replace Jabbour at the end of this month when the current election is complete. While highly unusual, this situation provided an opportunity for two exclusive, recorded interviews to contrast the two presidents and their views.
Most association presidents know approximately how many members they have. According to Acting President Saul, there are "around 1,500 to 2,000 practitioners and students." But ask President Jabbour the same question in an interview half an hour later, and he said, "I don't have those numbers available for this call, I'd be happy to provide them to you after this call." When asked to provide any "kind of ballpark" figure, Jabbour said, "Like I said, I would be happy to provide the numbers after the call."
Editor's Note:A significant number of questions had to be asked via e-mail due to Jabbour's inability to provide answers in our interview. The questions of membership numbers, along with many others, were not answered. The AAAOM leadership noted that they needed until April 15 - two months later - to provide this information.
However, publicly available information makes it easy to answer these questions. The AAAOM's own website directory shows "Member Types 1st Year Practitioner, 2nd Year Practitioner, 3rd Year+ Practitioner, Joint Member and Lifetime Member," totaling 481 members worldwide.
Other exclusive, recorded interviews with AAAOM insiders found that the actual number is "327," which was reported to the board last October. Both Jabbour and Saul were on the board at that time. Jabbour has been on the board as far back as 2010, and Saul has been on the board for more than a year. Assuming this last number is actually the correct one, this means that the AAAOM only represents a little more than 1% of the profession, hardly a faint reflection of the nearly 1,500 members the organization had when it began in 2007.
Membership, or lack thereof, is an issue that has concerned and disappointed many former board members.
"You can't have an organization that doesn't represent its members," said one source who wished to remain anonymous. "No professional organization operates successfully that way. The organization was not being governed by the states or by the members, it was by one or two leaders without a consensus."
When asked about plans for next year, Acting President Saul stated that the AAAOM was looking to introduce five bills into national legislation, update the membership structure, increase media exposure and re-instate the AAAOM's annual meeting.
President Jabbour was a little less ambitious as he listed, "distributing and building consensus around the competency model and revise the state model legislation and continuing to build our brand recognition at the national level so that when folks are looking for an answer related to acupuncture we will be able to provide that."
But when asked what challenges they faced, Saul stated that the primary challenge was "what role I can play to bring people to have a common vision and a common goal." Even when pressed, this was the only challenge he saw.
President Jabbour was more forthright in his assessment of the challenges, as he also included "bring the profession together under one single banner – uniting" and "finances." While acknowledging that finances were an issue, Jabbour didn't elaborate on any specifics. Missing from both presidents was a discussion about how they would build up the AAAOM's declining membership.
When asked how he became Acting President, Saul stated that "it was a complicated issue" and that after speaking to the current board, they felt they could manage the operational and functional capacities with this arrangement after Graham's exit. Saul was appointed by Jabbour, he said, with "the full support of the board." (The minutes of the Board meeting where Saul was appointed with full board support were among the requested information that was not provided.)
What makes this appointment unusual is that Saul only graduated from AOMA Graduate School of Integrative Medicine in Austin in 2012. If Saul really had the full support of the board, then the best candidate for the AAAOM presidency out of a profession of almost 30,000 practitioners is a person with only nine months experience as a licensed acupuncturist.
The current election process leaves a number of lingering questions including that, according to Saul, it will be a "non-competitive election" with all seats uncontested. According to Jabbour, they will be adding "five to seven additional board seats." The ability to expand or contract the board at will, combined with the apparent electoral certainty suggests a high degree of influence over who is on the board and who the officers are. This is supported by inside sources who note Jabbour often tended to fill the board with "inexperienced board members" who received no board training and are often left "in the dark" about a number of issues within the organization.
When asked how the organization justified having two presidents, Jabbour quipped, "it is not provided for in the bylaws, but it is also not restricted."
The Finances Tell All
As noted, Jabbour became the AAOM vice president in 2010. He took over as president in 2011. Here is how the organization has been impacted financially during the course of his leadership:
End of 2009
End of 2012
Assets Less Liabilities
The adjusted total revenue in 2012 dropped by more than 27% as compared to the 2011 total revenue. Yet according to the annual report, travel expenses more than doubled in 2012 as compared to 2011 ($16,775 vs. $7,989) even though there was no annual meeting in 2012. The "postage and shipping" expense also doubled from $6,144 in 2011 to $12,465 in 2012. That's more than $1,000 per month for shipping and postage in an era where electronic communications options could grow to offset rising postage costs. "Communications" expenses (the definition of which also went unanswered) in 2012 were more than three times as great as they were in 2011 ($17,659 vs. $5,153).
More recently, the AAAOM has had serious challenges in paying their bills. As AAAOM journal Editor-in-Chief Jennifer Stone noted, "I have concerns about the management of funds earned from the journal, and personally for 2 ½ years did not receive a promised stipend for services as EIC, despite formal attempts to seek payments. I have never been able to obtain P&L (Profit and Loss) documents for the journal, and hence cannot fulfill my financial management duties appropriately. I feel the journal has needed a separate bank account to better track operating expenses and income, but this has not been granted to date."
On December 2, 2013 the Ring Central phone company was forced to suspend service to AAAOM due to "several attempts" to charge their credit card, with payment being declined. According to inside sources, it was not unusual for other vendors to be left waiting for payment.
Currently, AAAOM is raising money for its Acupuncture Action Fund for "expert staff, lobbyists, legal services and consultants." Thus far, according to the website, they have "Raised To Date: $27,381" of the more than $3 million goal. But sources also confirm the bulk of this money or what has been collected has already been spent, mostly on "operating expenses."
By contrast, over the last two years the Consortium for Oriental Medicine Research and Education raised $300,000 in order to make acupuncture in the United States a recognized profession with the World Health Organization. The AAAOM doesn't appear to have the support of the usual funding sources within the profession.
A Pretend Agenda?
Although AAAOM has been able to outline numerous goals, it has not been able to fulfill a basic one – their annual conference, which has not been held since 2010. Since then, there have been numerous attempts to put on an annual event, but with no success due to the lack of funding and budgetary issues.
However, a quick glance at AAAOM's website and their annual reports continue to tell a conflicting story about the current status of the organization and their numerous unfulfilled goals.
When it comes to their annual reports from 2011 and 2012 the organization leaders use the words "making history" and noting the organization is "healthy from the inside and out."
In the 2012 AAAOM annual report, president Jabbour was so confident about the organization's stance in the profession he boasted in his annual letter that AAAOM was "on the path to progress, we're now on the cusp of making a real impact on healthcare in this country." He also noted that he was "confident" that by the end of this year "we will be able to carry even more optimistic messages of positive advances."
The report also noted that "thousands of hours" have been spent educating stakeholders nationally and that "millions" see their message in the media. There is also mention of federal and state legislative advocacy. But according to the AAAOM's 2012 Form 990 Schedule C filing – Political Campaign and Lobbying Activities, there have been zero lobbying expenditures since 2009.
Overall, the financial records show an entirely different picture that does not match the optimistic one outlined in annual reports.
While the requested information for the 2013 operations has not been forthcoming, it is not hard to predict what those reports will look like. Jabbour has already admitted that "membership has dropped like any other national organization." The 2013 annual report will likely show a drop in membership dues, as well as other sources of income. Probably the best the remaining members can hope for is that it won't be another year with a loss (expenditures over revenue).
Jabbour also noted that in order to be able to accomplish its current goals, $1 million to $3 million would be needed to do "what they would like to do." Sadly, the current revenue doesn't reflect anything close to this due to a lack of support.
"Unfortunately, despite the rhetoric, AAAOM currently does not have the support, volunteers, revenue, plan, relationships or credibility to meet any of the enormous challenges ahead particularly with respect to federal legislation," wrote former board member Daerr Reid in her resignation letter.
As former board member Jennifer Minor stated in her resignation letter, "AAAOM relationships with national and state leaders continue to deteriorate, with no financial plan or strategic plan in place, no funds specifically earmarked for federal legislation, no financial reserves, and the loss of so many capable, hard-working volunteers, it is not possible for the AAAOM to meet its lofty goals with respect to federal legislation under the current leadership or with the remaining board members in place."
Another source stated that the AAAOM had "no ability to pass national legislation or increase media exposure" and called their grandiose national legislation goals "unrealistic pipe dreams."
Former AAAOM president and founder William Morris admitted the organization is in serious need of a makeover.
"People need to come together with an integral vision. AAAOM needs to be in the same room breaking bread together with all its stakeholders in the profession and creating a new vision. I believe AAAOM is obligated to a higher level of transparency than that, that is required of other non-profit associations," Morris said. "This is an essential piece of building trust within the field and trust is the foundation of this profession."
These issues paint a tragic picture about the current status of the AAAOM leadership and the impact it is having on the profession. Other health care professions are competing in the race for health care reform, while the AAAOM stands motionless on the sidelines embroiled in power plays and exclusionist behavior.
An underlying attitude among many leaders within the profession is that they are unwilling to support the AAAOM until Jabbour is no longer leading it. This is consistent with the board resignation statements, falling membership and their inability to raise money from outside sources.
There are already conversations among disenfranchised leaders of other organizations about creating a new national association to compete with and eventually replace the AAAOM. Were this to happen, the profession would be split into divisive factions making it difficult to ever make headway on national issues.
*According to the 2012 Treasurer's Message in the AAAOM annual report, viewing the financial reports "on a cash versus accrual basis" gives a more positive total revenue figure. Both the (lower) accrual-basis total revenue and the (higher) cash-basis total revenue are presented even though the lower figure ($200,271) was the total revenue filed on the AAAOM's 2012 990 Form.
Update (February 25): Since this story has been published, the AAAOM's American Acupuncturist Journal associate editor Lynn Eder has resigned. Eder declined to comment, but has been working with AAAOM for numerous years. In addition, newly appointed board member Cynthia Clark has also resigned from her post within the organization. Clark joined AAAOM in December 2013. This brings the total number of board resignations to seven within the last two years: Elaine Wolf Komarow, Maya Noble, Zinnia Marvel, Kimberly Benjamin, Daerr Reid, Jennifer Minor and Cynthia Clark. They are accompanied by three executive director resignations in almost three years. With only 12 total board positions, the environment that prompted these resignations has left AAAOM in the hands of those that are expected to support Jabbour's agenda.
Update (March 7):
Who Is on Board?
On Day 7 of the regime of the new AAAOM board of directors, the members are still left in the dark about who is on the board, who is not on the board and who the officers are.
According to information that was formally on the website some of the new directors that are coming onto the board in the "non-compete" election have yet to be listed as directors on the website. It is still unclear if this is a list of every person who applied for a nomination or if this list has somehow been whittled down to a more preferred list. Either way, the new directors are being added without any involvement by the AAAOM membership.
According to the post on the website up to 12 of the following individuals could be on the new board:
Michael Jabbour, currently listed as president
Joshua Saul, currently listed as acting president
John Barrett, current listed as vice president
Jane Yu, current listed as secretary
Ann Y. Wang, currently listed as a director-at-large
Scott Cormier, currently listed as a director-at-large
Andy Rosenfarb, currently listed as a director-at-large
Jay Sexton, current listed as public director
Hannah Seoh, current listed as public director
Donnell Borash (HI)
Nicholas Haridopolos (CA)
Don Lee (CA)
Michele Louiselle (FL)
Jeanette Hoyt (public director nominee)
Cynthia Clark (FL) was previously listed on the website as a nominee and a director, but she officially withdrew from this election and resigned from the board effective Feb. 21.
Rumors suggesting that Joshua Saul will not be taking the "presidential oath" as the new president may be one reason for the delay in announcing the new AAAOM leadership. All efforts to arrange for a follow-up interview with the new president have been met with no response. But Acupuncture Today has received no less than five formal written statements from additional former board members and others involved along with statements from other sources that will be included in Part II of our report to be posted soon.