Chronic pain afflicts over 20% of the adult population. Sadly, most MDs have essentially no education in treating pain, beyond offering a few toxic medications. Then they tend to steer people with pain away from those health practitioners who are trained. This puts the acupuncture community on the front lines for addressing this epidemic.
AAAOM – The Beginning of the End (Part II)
Editor's Note: This is Part II of our series looking into the inner workings of the AAAOM.
To read Part I, click here.
UPDATE 10 A.M. PDT (March 25)
CSA Ultimatum, Jabbour Finally Responds, More Guild Members on AAAOM Board
According to several sources that were at the AOM leaders (AOML) meeting on Saturday, March 22nd, the CSA (Council of State Associations) surprised attendees by delivering an ultimatum to the current AAAOM board.
The ultimatum required all current AAAOM board members to vacate their board positions within 10 days and agree that the CSA would, at their sole discretion, replace them with new board members of their choosing. Should the AAAOM not comply, the CSA made known that they would launch a new national association to compete with the AAAOM.
When first contacted regarding the statements made at the AOM leaders meeting, CSA chair Tracy Soltesz stated "I simply am not at liberty to share information about the AOML with you." Soltesz said the meeting was not public.
However, after becoming aware that Acupuncture Today would be reporting on their actions, Soltesz responded: "We have recently communicated to other national stakeholders our collective desire to continue our evolution through the creation of a professional association that fully integrates state and national level associations in the field. While we would prefer to see this occur through the transformation of existing structures and organizations, we remain open to the creation of a wholly new organization if that proves to be the best available option for our members and for the profession."
Several of the other AOM leaders have privately expressed dismay over the CSA's actions, particularly the specter of two national associations trying to represent the profession.
Another surprise came on Friday, March 21st, when Michael Jabbour sent Acupuncture Today a 13-page response to the numerous questions he was unable to answer in his interview on February 11th. While still leaving many questions unanswered, the response was also published on the AAAOM website that same day.
When questioned about the response, Jabbour insisted that "the document is signed by the full board of directors." The document contains no signatures, just the words "AAAOM Board of Directors" at the end. Given that Jabbour reportedly still has control of the AAAOM website, AT contacted the remaining board members, none of whom responded to inquiries of whether they had read the response or approved it.
The final surprise came with the update of the Board of Directors page of the AAAOM website. Newly absent are the names of public directors Jay Sexton and Hannah Seoh (a coworker of Michael Jabbour at the New York City Department of Health and Mental Hygiene) and director Ann Y. Wang.
In their place, the AAAOM has also added the names of the most recent nominees Donnell Borash, Nicholas Haridopolos and Don Lee and two new board members, Dr. Carlos Chapa, DOM, Lac, PhD and Dominic Sembello, Lac, Dipl. Ac., who were apparently recently appointed. Both are reportedly current National Guild of Acupuncture and Oriental Medicine members.
Adding to the surprise is the fact that Michael Jabbour is still listed as the AAAOM president, despite his resignation statement of two days ago. Not coincidentally, he has also reportedly recently joined the National Guild of Acupuncture & Oriental Medicine.
That brings the total number of Guild members on the AAAOM board to four out of the eleven filled positions. AAAOM director Andy Rosenfarb is a Guild Vice President.
When asked a week ago about the possibility that the Guild and the AAAOM would somehow merge, Guild president Steve Paine remarked "The answer to that question is an unequivocal no." Since his remark, the number of Guild members on the AAAOM board has doubled.
UPDATE 10:30 PDT (March 21):
Under the threat of a resolution to demand his resignation, Michael Jabbour has resigned from the AAAOM board and his position as president:
"I'm pleased to announce both the seating of a new board and the completion of my term as president. I want to thank the profession for the honor of being able to serve. I look forward to handing off my duties to my successor who I expect will be selected within the next 2 weeks. Additionally, I want to express my deep gratitude to Joshua Saul who is completing his term as AAAOM Student Organization president and his service as acting president of the AAAOM. I wish him well and support the decision to grow his private practice.
"I have received the request from state association members to allow members more direct participation in the election of their national leaders. I am supportive of drafting appropriate rules to enhance the elections process. In order to accomplish this, all state and national stakeholders in the acupuncture profession should come together in the near term to determine the appropriate governance structure that will foster unity within the profession."
The AOM leadership will meet tomorrow, Saturday March 22 to determine how they will move forward to revive the failing organization.
UPDATE 2:30 PDT (March 21):
Acupuncture Today has learned that there will be a motion introduced at the AOM leaders meeting on Saturday, March 22 calling for Michael Jabbour's resignation.
Contrary to his recorded interview with Acupuncture Today, Jabbour is still acting as the AAAOM president even though in his own words he stated "that is correct, my term is up" at the end of February 2014. Acupuncture Today is closely following results.
In 2012, the AAAOM board members met in Chicago for their annual meeting. The goal was to come to a consensus on a long list of issues the AAAOM needed to work on including a functional board and budget. Leaders from the Council of State Associations (CSA) were also on hand to help mitigate the issues relating to the AAAOM's state association members, most of whom were also CSA members.
A facilitator was hired and an open dialogue was encouraged. All mistrust and individual agendas were asked to be put aside to collaboratively develop a finely delineated and actionable strategic plan with accountability benchmarks. The association was asked to look out for the good of the members and that of the profession.
However, instead of coming to resolutions, three board members resigned at the meeting, the hired consultant walked away disappointed and the open dialogue led to disagreements and disillusioned members.
The AAAOM leadership was warned: should they abandon the recommendations the association would run aground due to the significant financial troubles and in-fighting.
Fast-forward to today and those predictions have come true.
THE CHICAGO IMPLOSION
When AAAOM needed both planning and training sessions, they called Renata Rafferty. She was reportedly hired by AAAOM president Michael Jabbour.
According to Rafferty, she facilitated both planning and training sessions for the AAAOM and the CSA on two separate occasions approximately a year apart, and participated in numerous conference calls and meetings with board members and board leaders over the course of that period.
Rafferty was also hired as a facilitator for the Chicago meeting that took place in 2012. According to former board member Maya Noble, Rafferty's opening remarks at the meeting were to "verbally admonish" Michael (Jabbour) and (former AAAOM president) Jeannie (Kang) for not heading one word of her advice, not implementing any of the changes that were to have been made, and for taking part in "modern trench warfare against the new board members."
"She opened our session with an angry statement saying none of the action items agreed on at the last conference had been accomplished. She further predicted the demise of the organization. She said it could not survive being run the way it was run. I agreed with her logic," recalls former board member C. Zinnia Maravell in a written statement to Acupuncture Today.
According to Rafferty, most of the issues of AAAOM stemmed from governance, mutual respect for all board members and transparency with financial and legal information.
"I made clear to the board and to the CSA leaders that unless AAAOM could show tangible progress and deliverables on even a few tools that members could put to use right away, what little goodwill and faith AAAOM enjoyed among its members in 2012 would disintegrate," said Rafferty. "Committees and task forces began immediate work on many of these initiatives, but a chokehold was put on their progress every step of the way as Michael (Jabbour) continued to force his agenda through control of the executive committee and the association's budget."
The result of the year-long effort was a meeting with the CSA leadership of which Noble reports "the final straw came when we were asked to sit in front of the CSA as a member of the AAAOM board of directors and represent a unified front behind a string of falsehoods. We were asked to not air our dirty laundry. Knowing what I knew about the workings of AAAOM, I felt I was being asked to lie about the solvency and legitimacy of the organization and what I felt were deliberate misrepresentations being made to its members."
UNHEALTHY ENVIRONMENT = BOARD RESIGNATIONS
After a failed effort to remove Jabbour as president, three of the board members resigned at the end of the Chicago 2012 meeting. A fourth board member, Mori West, was taken off of the board just before the meeting. They describe the environment as less than functional. Each board member has a recollection.
"I resigned because it was clear that I would be unable to fulfill my responsibility to the members of the AAAOM," noted former board member Elaine Wolf Komarow. "Decision-making was always in crisis mode, without supporting documentation. We were asked to make financial decisions without a working budget. The bylaws were not being followed, committees were not meeting and/or reporting to the full board, time and effort was not allocated according to stated priorities. We did not receive minutes of past meetings in a timely fashion yet were told that something had already been decided. There was questionable voting and vote counting during the election of the officers. We were told the lawyer had 'concerns' about a whistle blower policy, but neither MJ (Michael Jabbour) nor the lawyer would give specifics as to the concerns. I was told that there was a voting bloc that would maintain the status quo and that those who didn't support the current leadership might as well step down as they would never succeed. I was told I was unfit to serve on the Board. It became apparent the dysfunction was well entrenched. Without board insurance and regular independent audits, without official legal counsel for the organization, I would have been at legal risk to continue."
Former board member Zinnia Maravell agrees.
"After being officially appointed, and sitting through some more totally senseless, purposeless meetings, I thought this is a waste of my time. I am not going spend my life force trying to make this organization work. Mori (West), Maya (Noble) and Elaine (Wolf Komarow) were also resigning. None of us could take the abusive atmosphere. I resigned because life is too short to waste it on meaningless conflict."
In her written statement, Maya Noble had the most to say. Noble noted that "questions raised as to the validity of any topic of discussion or proposed plans were met with verbal tirades and attacks."
In addition, Noble noted the hostile atmosphere of the board meetings.
"Board meetings via phone conference felt more like barroom brawls with a total lack of professionalism and common courtesies, the like of which I had never seen outside of a Jerry Springer show. It became very evident very early on that this organization was being run in a manner that I felt would compromise my ethics and integrity," Noble said.
After Noble noted what she called an "unethical ousting of Mori West and a stacking of the board, and once MJ (Michael Jabbour) was at the helm of presidency, motions were introduced to essentially silence anyone from speaking the truth of what was really happening behind closed doors."
"MJ (Michael Jabbour) made it quite clear that (there) was no whistle blower protection in AAAOM and our verbal no confidence votes against Michael placed Zinnia, Elaine and myself as well as Mori directly in his and Jeannie's (Kang's) line of fire. Having been subjected to months of verbal abuse and silencing, and being asked to further perpetuate falsehoods, I felt that I could no longer be associated with the AAAOM and in the face of that current regime, would be unable to affect any positive changes. To remain on its board of directors and in association with the organization would compromise my ethics and integrity, and the stress of that association I felt would eventually affect my health," Noble said.
On the morning of April 29, 2012, Noble made a statement to that effect and stepped down as a board member along with Zinnia Maravel and Elaine Wolf Komarow.
With three board member resignations then and five additional board member resignations this past year, Rafferty said she is not surprised.
"I know how frustrated they (board members) were and how difficult they found it to work with Michael, but they stayed on in order to protect the interests of the members and the integrity of the association, paying a price in their personal and professional lives to do so. I am surprised they continued to try and fight the good fight for what AAAOM could/should be for as long as they did," said Rafferty.
Rafferty said she was also witness to the dysfunction of the board many times.
"I have heard him (Jabbour) speak of and treat board colleagues and others trying to help him and the AAAOM with suspicion and paranoia. That prompts him to hold information – and authority – to himself. For example, for years he insisted that he alone develop and control the software code for much of the AAAOM's records. When the 'majority of the board' did not want to go along with his proposed direction, he saw no issue in moving – against the majority – in his own direction. That's not how boards are structured or empowered to be treated. The reason the law requires a board is so that no one person can control an entity created for a shared group benefit," Rafferty said.
As of this date (March 18, 2014) a total of eight board members have resigned in the last two years. The most recent, Cynthia Clark and Michelle Louiselle were "non-compete" nominees resigned in the last month prior to their first Board meeting.
LOSS OF MEMBERSHIP RIGHTS AND BENEFITS
The benefits of membership are the reasons why practitioners pay their hard-earned money to become members of any organization. Membership has its privileges, but in the case of the AAAOM, those benefits appear to be waning.
As previously reported, the AAAOM has not held its annual meeting since 2011. Given the significant drop in membership and revenue since that year, it is unlikely that there will be an annual meeting this year as well.
Another right of membership is access to information. Eighteen days after the "non-compete" elections were to take effect, the members are still in the dark about who the officers are and the complete list of directors. The Board had a two-day meeting via conference calls on March 16th and 17th. After the first day, they sent out an e-mail newsletter which stated:
"The AAAOM welcomes Donnell Borash from Hawaii, Nicholas Haridopolos from California and Don Lee from California in joining the Board of Directors."
Jeanette Hoyt, the public director nominee, was conspicuously absent from this announcement, suggesting that she has not joined the Board.
Immediately after the second day of the conference calls, the Winter 2014 issue of The American Acupuncturist journal was posted on the website in PDF format. Rather than present the new directors and officers, page seven of the journal lists the previous board of directors including Cynthia Clark who resigned weeks ago. This decision to not provide the updated board information deliberately causes further confusion for the members.
What makes the information even more peculiar is the apparent interchangeable nature of the titles. Joshua Saul is listed as the "Acting President" on the website but is listed as the "Treasurer" in the journal. This is even more curious given that he is not listed as the Treasurer in the most recent AAAOM Annual Report nor on the most recent Form 990 filed with the IRS. John Barrett is listed as the "Vice President" on the website, yet he signed the most recent Form 990 as the "Treasurer" and is also listed as such on the most recent annual report. The website fails to list anyone as the Treasurer.
Based upon an earlier statement by Rafferty, the above seems to confirm that Jabbour is still in control of the organization: "He (Jabbour) hoards information - information that by law and common sense - must be available to both the leadership and membership of an association in order for it to operate in the best interest of its constituents."
The ability to elect leadership is probably the most important membership privilege. But the previous three elections have been "non-compete" elections; which don't involve any balloting by the members. This means that the AAAOM membership has had no involvement in the election of the vast majority, if not all, of their current board members.
How the AAAOM's "non-compete" elections work is still a mystery to many of the former board members. The membership is presented with a list of names of members who have "completed the application for nomination." There is no explanation on the website if this is the list of all nomination applications received or if this list has been modified by someone who ultimately selects the new AAAOM directors. Interestingly enough, the final list of nominations is always just the right number to fill some or all of the vacated board positions without the need for an election by the membership.
One reason why this process seems to work is that some board members are terminated to create a vacancy for newly nominated directors to fill. This keeps all board members aware that they can be replaced at any time.
Former AAAOM board member Mori West explains "It was at the Chicago meeting (that) all four of us were going to step down together when Michael called a board meeting right before and announced the executive board had met and it was time to get a new public director, my time was up. The two public members he proposed are the two that are there today, Jay (Sexton) and Hannah (Seoh). Hannah worked with Michael at the NY dept of Health and I think Debra (Lincoln) knew Jay, not sure where he came from. I don't think either were even members of the association before that time. So I was out."
Former Board member Maravell relates a similar experience.
"At some point before I was officially appointed, I received a call from Deborah Lincoln and Michael Jabbour suggesting that I would be happier if I were not to become a board member. I thanked them for their concern for my happiness. I told them I was perfectly content."
Hannah Seoh who replaced Mori West as a public member on the AAAOM board at the ill-fated Chicago meeting is listed as a "Program Evaluator/Data Specialist" for the New York City Department of Health and Mental Hygiene. She works with Jabbour who is a "Senior Project Manager" at New York City Department of Health and Mental Hygiene. The fact that they work together outside the AAAOM board apparently isn't considered a conflict of interest.
In addition to the "non-compete" elections, the by-laws were amended at the Chicago meeting to give greater control to the "voting bloc" on the board and reduce the role of the membership in the election process. Here is the exact wording from the current posted bylaws:
- Section 5.7
An alternate director shall fill the position of a voting director if a vacancy should occur. The board may appoint up to four (4) there is a vacancy and there are no alternates. - Section 4.3
A quorum of five percent (5%) of the voting membership (calculated as the total sum of the votes eligible to be cast by Individual Voting Members) shall be required to elect a board director, make a bylaw amendment, or pass a resolution.
Based on the current membership estimates less than 30 members are required to elect board members and change the bylaws (the actual membership number, which was requested on February 13th, has still not been provided). This actually encourages poor communication by those who hold the majority of votes on the Board.
The bylaws also put the election of the officers in the hands of the board, not the AAAOM members. This empowers those in control of the board to also control who the officers are and who is on the executive committee.
Komarrow notes "The biggest concerns – the AAAOM has become irrelevant at best and damaging at worst. They have provided no direct ongoing benefit to working practitioners."
Rafferty said the fact that Jabbour has never been a full-time acupuncturist and has not had to rely solely on acupuncture to provide a livelihood for himself is why he "can't connect to the practical needs of full-time – often struggling – practitioners. He has the luxury of being able to focus on lofty legislative goals when his fellow members need specific help to get more clients in the door. That's what they hope they will get by paying their hard-earned membership dues."
Rafferty said what the rest of the board, and CSA representatives, as well as other allied entities tried over and over to make clear to Jabbour and his shrinking band of supporters was that "the members were paying dues and remaining committed to AAAOM for the many direct benefits that AAAOM could offer its members if it only tried."
THE PROGNOSIS
Given the challenges facing the AAAOM, one has to wonder what should happen next. Sadly there is consensus on this as well.
All former board members agree the current organization should disband because the association's negative baggage far exceeds any good and they find themselves at a place where they can't provide the most basic resources to working practitioners. A recent Acupuncture Today poll also showed 56 percent think the organization should rebuild with new leaders.
Maravell sums it up this way, "from what I observed, I think the best thing would be for AAAOM to disband. If there is any money left, divide it among the state associations."
Noble is more emphatic, "I felt that those in charge of the organization were acting in ways that were unethical and dishonest and would cause the AAAOM to crash and burn. I felt those in charge were running the organization in such a way to suit their own needs and agendas with no regard for its members."
Rafferty agrees.
"My professional opinion is that AAAOM should be put to rest, and no further resources – human or financial – should be invested or expended," Rafferty said. "This physician has not been able to heal itself, even with the concerted heart, energy, effort, plans and best counsel of professionals like myself and leaders in the AOM field. I hope that maybe, in some small way, what I have shared will help shed light on how this all happened and how it could have been avoided."
Despite the issues presented in this and the previous article, the profession is still in need of a national organization. What is painfully clear is that the AAAOM will only be able to meet that need with new leadership.
Please see all Supporting Documentation and References at acupuncturetoday.com/aaaom.
Editor's Note: Acupuncture Today has sent e-mails to all board members as well as additional e-mails and made phone calls in an effort to conduct an interview with a representative of the AAAOM regarding the above issues, who the directors and officers are and unanswered questions from our previous interviews. We have not received an official response as of March 19, 2014.