The Florida Association of Oriental Medicine (FAOM) has sent a letter to the Florida Board of Chiropractic Medicine regarding the board's intention to update an administrative rule regarding the practice of acupuncture. A copy of the FAOM's letter is included below for review. Interested parties may also visit the "public forum" section of FAOM's Web site (www.faom.net) for more information and updates.
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FLORIDA ASSOCIATION OF ORIENTAL MEDICINE, Inc.
4505 West Flagler St., Suite 202
Miami, Florida 33134
866-399-3038; ; www.faom.net
May 19, 2004
To the Board of Chiropractic Medicine:
The Florida Association of Oriental Medicine wishes to address the subject of your recent intention to 'update' an Administrative Rule respecting acupuncture. We cite herein your expression of intention as being an Application for Acupuncture Certification 64B2-11.012, Board of Chiropractic Medicine, The Board proposes to update the existing rule text. SPECIFIC AUTHORITY: 460.405 FS. http://www.flsenate.gov/Statutes/index.cfm?App_mode=Display_
We demur to any issue of standing regarding Acupuncture; however, the Legislature in its wisdom has conferred upon two regulatory boards differing meanings for it, thereby creating a conflict in law.
This conflict is rooted in the disparate standard that each Board has created with the result that the public will construe incorrectly that the procedure of acupuncture stands with equanimity amongst all providers and, furthermore, is in jeopardy of harm when it is applied in the absence of appropriate requisite diagnostic application. See British Medical Journal, 2001; v323,Increased adverse reactions and events. With patients treated by providers who have substantially less training than one who is licensed.
The Florida Association of Oriental Medicine seeks to cause the Board of Chiropractic Medicine to recognise this disparity and in furtherance of its primary charge of protection of the public to amicably reconcile this conflict.
Doctors of Oriental medicine must complete some nineteen hundred hours of academic training in the concepts and diagnostic methods of Traditional Chinese Medicine as a pre-requisite to the taking of a national board exam and approved licensure for practice in the State of Florida. This is the established standard for the protection of the public as determined by the Department of Health and our regulatory Board.
Doctors of Chiropractic Medicine must complete an elective of some one hundred hours of training consisting in the history/philosophy of acupuncture in a chiropractic setting, organs, qi and fluid, channels/pathways, acupoints, acupuncture techniques, basic treatment tenets and protocols, and safety and hygiene. http://www.nbce.org/news/print_mar_04_report.html
We assert and argue that the substantive nature of this material requires the minimum standard of some nineteen hundred hours of academic and clinical training as recognised by the Department of Education and the Accreditation Commission of Acupuncture and Oriental Medicine (ACAOM); that the National Board of Chiropractic Examiners does not meet this standard; that the difference is of a material nature; that the National Board focused on acupuncture as an adjunct therapy in the chiropractic setting; that acupuncture is not an adjunctive therapy as defined by FS 457; that the Board of Chiropractic Medicine can reconcile this issue by assenting to the minimum standard of training aforementioned.
FS 460.403 Definitions (9)a, defines the practice of chiropractic medicine and identifies the practice as being involved with the art of manipulative techniques and procedures.
We make note here that acupuncture is not a manipulative procedure, nor is it properly referred to as a natural method.
FS 460.403 (9)c1 gives authority to this Board of Chiropractic Medicine to certify the use of acupuncture.
We make note here that this stands in conflict with the regulatory Board of Acupuncture's primary responsibility in overseeing for the protection of the public welfare the definition of acupuncture, which Board has been given the principle Right by the Legislature to establish the standard for the procedure of acupuncture, and the training requirements necessary to satisfy the protection of the public; that this primary position regarding acupuncture is inherent in the Legislature's expression by the distinction of contrasting the language of FS 457 and FS 460, wherein there is a mere mention of acupuncture in FS 460, and a comprehensive definition in FS 457.
FS 460.403 (9)f requires that this Board of Chiropractic is the Certifying entity, and tested by the Department; that the requirements to be met by an accredited College and recognized by an accrediting agency.
ACUPUNCTURE TEST COMMITTEE
We make note here that this creates a separate course of evaluating acupuncture; its training and its testing, on a path separate from those who are licensed by the regulatory Board of Acupuncture; that this has resulted in a conflict in law.
This has resulted in at least a dual path of training for the procedure of acupuncture, one for those seeking Certification and regulated by this Board of Chiropractic and the other for those who are seeking Licensure and regulated by the BOA.
We offer for your edification FS 457:
457.102 Definitions. -- As used in this chapter:
(1) "Acupuncture" means a form of primary health care, based on traditional Chinese medical concepts and modern oriental medical techniques, that employs acupuncture diagnosis and treatment, as well as adjunctive therapies and diagnostic techniques, for the promotion, maintenance, and restoration of health and the prevention of disease. Acupuncture shall include, but not be limited to, the insertion of acupuncture needles and the application of moxibustion to specific areas of the human body and the use of electroacupuncture, Qi Gong, oriental massage, herbal therapy, dietary guidelines, and other adjunctive therapies, as defined by board rule.
(6) "Oriental medicine" means the use of acupuncture, electroacupuncture, Qi Gong, oriental massage, herbal therapy, dietary guidelines, and other adjunctive therapies.
The failing and resulting harm to the public is that acupuncture is a procedure requiring appropriate and extensive academic training in the theory and diagnostics methods of Traditional Chinese Medicine. The Board of Chiropractic Medicine has profoundly overstepped its bounds of manipulative procedures by assuming to itself a procedure that its license holders are not currently trained nor appropriately tested, and herein seeks to modify the requirements such that there will occur in Florida two paths for those who use acupuncture. Either one is grossly over trained or the other is grossly under trained, with the net affect that the Legislature has created a clear conflict in law that now begs for redress. Clearly the supervising authority is the Board of Acupuncture on this issue and we therefore seek the Board of Chiropractic Medicine to respond to our concerns as doctors of oriental medicine and the protection of the public who assume that the Department of Health has a singular regulatory Board, which resides its purview over acupuncture. It cannot continue to be bifurcated as it has been. There ought not to be a path for certification and another for licensure as the training is rooted in the entirety of Oriental Medicine and its numerous diagnostic methods as a pre-requisite to the application of the procedure of acupuncture.
We, the Florida Association of Oriental Medicine, are desirous that this conflict in law find resolution within the body of the Board of Chiropractic Medicine; that the furtherance of its authority for certification, FS 460.403 (9)f, find accommodation and reconciliation of this conflict; that there occur an explicit expression of an assent to the training and testing per the minimum standard set forth by the Accreditation Commission of Acupuncture and Oriental Medicine and recognised by the Department of Education; that nothing less will support the primary obligation of the Department of Health realize that standard of care that will satisfy the protection of the public and a furtherance of our credo as doctors, to do no harm.