After two days of extensive meetings, representatives from more than two dozen California acupuncture associations have reached an agreement to form the National Guild for Acupuncture and Oriental Medicine.The guild marks the creation of the first true national acupuncture labor organization in the United States and exemplifies the amount of progress the profession has made toward unity in the last few years.
"There is a guild, and we're going forward, and we're just going to start building from this point," said Ted Priebe, an acupuncturist from Torrance, California who was named president of the new organization. "Basically, there wasn't any dissention at all - we're all on the same page, which is kind of unusual, but we all have the same goals."
At the meetings, which were held in Los Angeles in June, officials from 25 acupuncture associations throughout the state agreed to a basic set of bylaws for the creation of the guild. They also elected a group of pro-tem officers for the organization and submitted a revised set of bylaws to the American Federation of Labor-Congress of Industrial Organizations (AFL-CIO) for acceptance.
The guild will be comprised of numerous "chapters" that will each have voting rights. Chapters will consist of existing local, state and national acupuncture associations that decide to join the guild.
Guild membership will be open to licensed or certified acupuncturists and Oriental medicine doctors across the country. Acupuncture students are also eligible for membership, while non-practitioners and other advocates of the profession may join as associate members.
In order to belong to the national guild, acupuncturists must also be members of a participating chapter. The strategy behind this is two-fold. In addition to increasing the size of the national organization, smaller state and local associations would gain strength by increasing their membership base as well.
New Possibilities for Acupuncture and Oriental Medicine
The creation of the guild is expected to open several markets for the acupuncture and Oriental medicine professions. By joining the guild, acupuncturists will find themselves linked to some 13 million members of the AFL-CIO. Those members belong to union-negotiated health care plans that cover upwards of 45 million people in the United States. As the nation's largest group of health insurance buyers, union members could demand that acupuncture benefits be included in their health care plans, creating a huge patient base that was heretofore largely unavailable for acupuncturists and Oriental medicine doctors.
"This is another group of professionals who are pretty much estranged from the current health-care scheme and who are working to develop the appropriate recognition for their trade," said Alan Elnick, an organizer with the Office and Professional Employees International Union (OPEIU). The OPEIU is the organization through which the acupuncturists will be affiliated with the AFL-CIO. It played a major role in the formation of the guild and the writing of the guild's bylaws. In the past, OPEIU has helped form similar unions for podiatrists, nurses and social workers, including the National Guild of Medical Professionals.
Guild membership could produce other benefits as well. As members of the AFL-CIO, acupuncturists would gain valuable lobbying access to legislators in the United States and Canada, which could help expand the legal recognition of acupuncture to every state in the U.S. Guild members could get access to union discounts on health care benefits and have more power in negotiating standard health benefits. Acupuncturists could also have union representatives review contracts prior to their joining a managed care network to make sure they receive fair pay for the care they deliver.
A possible future benefit for acupuncturists would be the ability to bargain collectively. While health care providers are prohibited from collective bargaining under U.S. antitrust laws, legislation currently under consideration in the House of Representatives would give them that right.
"Inevitably, the direction is to allow independent contractors to bargain collectively, unimpeded by antitrust laws, but we need to set up structures to do that," added Elnick.
Leaders Appear Guarded but Optimistic
Reaction to the announcement of the guild has been somewhat mixed to date. While some acupuncturists have expressed concern about being affiliated with a large union, others have welcomed the opportunity.
"There's strength in numbers," said Karen Nunley, secretary for the Texas Acupuncture Association. "With managed care coming down the pike, we need help in negotiating."
Other practitioners have adopted a more cautious stance.
"I'm taking a wait-and-see attitude to see how they move and how they're dealt with fairness-wise," said David Molony, executive director of the American Association of Oriental Medicine. However, Molony did wish the new organization well, adding, "I hope everything works out for them."
Although the initial groundwork for the guild has been laid out, a number of issues will still need to be resolved before future progress can be made. Among the most important are the voting rights of associate members and the types of benefits included with membership.
"For the most part, our people are eager and interested" in joining the guild, said Benjamin Dierauf, president of the California State Oriental Medical Association.
"I'm very excited about it," he added. "I think there is a lot of potential in making a strong alliance politically and economically so that we can provide quality health care."
Dierauf did express some concern regarding the guild's membership dues, which will cost $10 per month. "Other than that," he said, "it looks like a win-win situation for the union and for acupuncturists."
Whatever the price of joining, such dues "are going to be very reasonable for the members," said Priebe. "They will be cost-effective and definitely a win for everybody. The benefits will far outweigh the costs."
The Importance of Membership
What will membership in the guild bring to the individual acupuncturist? For one thing, unity. While most acupuncturists in California already belong to any one of a variety of acupuncture groups, many of these organizations are hampered by geography, small membership and differences in language.
According to Priebe, being part of a guild would unite these smaller groups into one larger organization, giving them greater bargaining power and a stronger political voice. This would help raise awareness of acupuncture and Oriental medicine to the public, medical providers and the insurance industry while educating them about the benefits of such care.
"Acupuncture and Oriental medicine really is no longer alternative; it's complementary to Western medicine," said Priebe. "This is one effort to bring everyone together in order to have better ways of negotiating with insurance companies, setting standards throughout the industry, and bringing people the services they want."
"This gives us a better way to inform the public, the medical community and legislators about what acupuncture and Oriental medicine actually are and how it fits into the health care service."
"We need to look out for the interests of acupuncturists, and the unions have made the case that they are willing to do this," added Lloyd Wright, an acupuncturist from Palo Alto and the guild's vice president. "Insurance companies are telling these guys how to practice medicine, and cutting their fees to unmanageable levels. Maybe medicine had some fat to cut in the 1980s, but acupuncture has no fat to cut whatsoever."
The formation of the guild is expected to become official July 1, pending approval of its bylaws. The guild is also in the process of extablishing a toll-free number for those interested in learning more about the benefits of membership. In the meantime, associations and individual practitioners who would like more information are encouraged to contact Dr. Priebe directly at (310) 325-8054.