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.
AAOM Heads in a New Direction
On June 1, 2004, Rebekah Christensen officially assumed the role of executive director of the American Association of Oriental Medicine (AAOM), after serving in the same capacity for the California State Oriental Medical Association. As executive director, Ms. Christensen is responsible for overseeing most of the AAOM's day-to-day functions, and has been instrumental in the association's relocation to its new national headquarters in California. She has also taken a leadership role in finding solutions to many of the problems the Oriental medicine profession currently faces.
In this interview with Acupuncture Today, Ms. Christensen discusses her role with AAOM, the reasons for the association's move to California, and the efforts AAOM is making toward working with other organizations and protecting the rights of licensed acupuncturists across the country.
Acupuncture Today (AT): How did you make the transition from CSOMA to AAOM?
Rebekah Christensen (RC): I felt the profession needed to experience far greater unification on a national basis, so I called Gene Bruno to propose some ideas I had to work with California and CSOMA, and likewise other associations across the U.S. At the time, I was unaware that the AAOM was looking to make a change in their management. Dr. Bruno's instinctual response was, "How would you like to work with our board in developing some of these ideas as our executive director?"
The reality of the transition took far greater discussion between many parties, in California and nationally. Beyond the door to this opportunity opening in such an unexpected manner, I felt it was the next step I needed to take to expand my ability to give back to the profession. From the perspective of California, I saw this as opening a whole new door for meaningful collaboration to occur. To that extent, we sent a formal invitation to invite the presidents of all of the state associations, as well as students and the practitioner community, to participate in a "president's roundtable" at our conference in Las Vegas for the purpose of collectively shaping the future of Oriental medicine. We also sought input from preregistered participants to establish the meeting agenda.
A follow-up report after the meeting will outline what I anticipate as a quite tangible "Oriental medicine unification roadmap." This is an historic event that has allowed us to collectively identify concrete steps for immediate implementation. In collaboration with this, AAOM will soon be announcing a unique nationwide membership program, which is designed to grow and empower state and national interests equally.
AT: What were the AAOM's reasons for relocating from the East Coast to California? What has been the reaction from the AAOM's membership to the move?
RC: The answer is three-fold. First, the AAOM Board of Directors realized that to continue to meet escalating growth, as well as dynamic professional and operational demands, they would need to find a new management group with more experience in the field of Oriental medicine to assist with these challenges. Likewise, if I was to assume the position of executive director - well, California is my home, and moving to Washington, D.C. was not an option for me.
Second, California represents the largest practitioner base in the country. In expanding collaboration between the state associations, AAOM's close proximity to such an extensive practitioner base would be valuable as California has demonstrated a keen desire to collaborate, and has a myriad of resources that can be collaboratively shared with others.
Lastly, the board of directors is comprised of practitioners from across the United States, and with the sophistication that technology affords us all, a national association can function equally well from any geographic location.
The reaction from the membership has been quite positive; in fact, we have not received any complaints that I am aware of. Having said that, I'm the first one to admit that moving a 23-year-old organization from coast to another is an arduous task, but it now appears that most of the administrative and operational bumps in the road we first experienced are behind us.
AT: What are your job duties like at AAOM, and how do they compare to the job you held with CSOMA?
RC: The roles and responsibilities of an executive director are relatively parallel, with the exception that with CSOMA, I represented California only, while in my position with the AAOM, the geographic radius is 50 times greater. Kindred to CSOMA, I'm responsible for overseeing all day-to-day fiscal and operating issues to include membership, conferences and expositions, publications, new program development, design and implementation, hiring, staff training, legal and compliance issues, etc. For CSOMA, I took on the task of educating myself about practitioner compliance under California's scope of practice, but when I look out the window, there are now 49 other states staring back. Gaining this type of knowledge on a national scale seems daunting. To that extent, we are looking at ways that technology can bridge this distance so that we can access and become better aware of not only current scopes of practice, but equally, opportunities, issues and concerns that each state might experience, but that ultimately impact us all.
AT: What's the biggest difference between working for a state association versus a national association?
RC: A few things come to mind. Like I just said, there's the magnitude of representing an association that encompasses 50 states versus one. Sometimes, the sheer volume of work takes your breath away. You must also create a "fairness of opportunity" in that the needs of each state must be addressed equally. It also reinforces what I've always known: We live in a global community. What impacts one state, impacts the whole. I feel collaboration and unification within the profession is an integral component of our profession's growth and expansion.
AT: About the AAOM: While it's arguably the largest member organization in the AOM profession, it's not the only one. How does the AAOM with other organizations - the AOM Alliance, the VSTF, the Acupuncture Guild, the AOMNC, etc. - to make sure you're all serving the best interests of the profession?
RC: Earlier this year, Gene Bruno mentioned that one of the more significant changes we've seen in the last few years is that many Oriental medicine organizations are actually communicating better and working more closely than ever before. The VSTF is just one example of this cooperation. The AAOM is working closely with ACAOM by participating in a doctoral task force, and other national organizations are participating equally. The AAOM also communicates regularly with FAOMRA, and supports its efforts to involve more regulatory agencies in its work. The AAOM has been working together with the Alliance to create an ethics statement. This closer network of communication is encouraging and essential so that all of these organizations can serve the best interests of the profession.
AT: One of the biggest concerns to the profession is that other health care providers are continuing to push for the ability to practice acupuncture. The American Chiropractic Association recently founded a college of acupuncture and created a new certification exam for chiropractors. What is the AAOM's stance on chiropractors practicing acupuncture, and the college of acupuncture?
RC: The attempt by members of other professions, including chiropractors, to acquire the right to practice acupuncture with minimal, inadequate training has increased dramatically. This is a major concern to the AAOM and all other responsible national and state AOM organizations. Since the mission of the AAOM is to preserve and protect the integrity of acupuncture and Oriental medicine, it's a full-time job working with various states where chiropractors are trying to get new privileges with insufficient training. In this capacity, we work with state organizations and licensing boards regarding the standards of education that are necessary for acupuncture in order to protect the public trust. The fact that chiropractors are allowed to practice acupuncture in some states with entirely inadequate training should alarm all adequately trained practitioners.
The best example I can give you of a situation in which a state recognized that acupuncture is in fact a complete system of practice and not just a technique, and also where they recognize that full basic training underlying Oriental medicine is necessary in order to ensure public safety and trust, is in the state of Hawaii. A recent Attorney General's opinion there clearly laid out why medical doctors can't practice acupuncture without full training. It is the AAOM's objective that more states see the situation the same as Hawaii. The AAOM has many members who are naturopaths, chiropractors and physicians who have studied full programs that are not limited to an inadequate 200-hour program. These professionals would be the first to tell you that arguments that have been made in an attempt to separate the principles and theories of Oriental medicine from acupuncture are simply frivolous. So again, it is the AAOM's position to work with states to stop or curtail the misuse of our system of medicine by undertrained practitioners.
AT: There's also the issue of the Accreditation Commission, which last year altered its bylaws and removed three commissioners from its board. What is the AAOM's opinion of ACAOM's actions?
RC: The AAOM's input from membership indicates an overwhelming preference for a focus on the legal access to herbs than the actions of a private organization in the fulfillment of its mandate with respect to day-to-day affairs. Practitioners are justifiably more concerned about their ability to have access to medicinals such as ephedra than whether ACAOM should hire a new secretary. Practitioners have also expressed to us that they are more concerned with the AAOM working with their states to provide adequate scopes of practice for practitioners. To that extent, from the point of view of the input from membership, what has been described as a hot issue is, in fact, not an issue at all.
AT: What other issues is the AAOM working to address this year, and what are the big issues AAOM sees facing the profession in the next few years?
RC: Operationally, as I stated previously, we are looking at ways to enhance the resources and collaboration between the states as well as nationally. We're designing ways that technology can better link our ability to communicate and share information. We're working on the design and implementation of a national health care program for practitioners and students. The Oriental medicine community will see what we feel are giant steps in enhancing our member benefits.
Professionally, we have a wide-ranging strategic plan that includes working on states that have no licensing laws yet, and we're working closely with states that need help improving their scope and standards of practice. In addition, we will continue to work with ACAOM to develop the first professional doctorate. We are looking at new ways to have an impact on coverage for acupuncture under the federal employees benefit program. Also, although it is a slow process, we are still working closely with the FDA to protect practitioners' access to herbs.
AT: Given everything that we've talked about, in your opinion, is the AOM profession in better shape or worse shape than it was five years ago? Will it be in better shape or worse shape five years from now?
RC: It has been 30 years since the first licensing law in the U.S. was passed in Oregon. In these 30 years, acupuncture has moved forward at an astonishing rate. What I mean by "move forward" is that the public, legislators and other health professionals, and the scientific community have increasingly seen the amazing benefits that acupuncture and Oriental medicine offer in public health care. Given the growing strength of the profession and the state and national organizations, it's like that line from the old 80s song - the future's so bright, we gotta wear shades. Humor aside, prominent research conducted by Beth Israel Deaconess Medical Center in Boston in 1990 and 1997 revealed a 47 percent increase in alternative medicine in the U.S. More importantly, visits to practitioners of alternative medicine exceeded visits to primary care physicians by 396 million in 1997. Clearly, our future is now, and is ours for the taking.
In closing, I want to say to the practitioners out there that they should see the importance of joining their state organizations and the AAOM and supporting their work. Your state and national associations are a major part of why you have this opportunity to practice this medicine that you have worked so hard to master. It's important that practitioners understand this. By participating in your state and national organizations, your contributions and ideas will help to shape your own future. I'd also like to thank Acupuncture Today for allowing me this interview.