Spotlight on the National Acupuncture and Oriental Medicine Alliance: An Interview With Dr. Michael McCoy, Part Two

In the March issue, Acupuncture Today spoke with Dr. Michael McCoy, the executive director of the National Acupuncture and Oriental Medicine Alliance, about changes in the Alliance over the past few years, and the impact of a doctoral program on the acupuncture profession. In the final part of our two-part interview, Dr. McCoy talks about the importance of research, legislative developments and other areas of interest to acupuncturists, their patients and the general public.

Acupuncture Today (AT): There seems to be a lot more research being published on acupuncture and some forms of traditional Chinese medicine, especially tai chi and qigong. How important do you think this research is to the profession in general, to the regular acupuncturist in particular and to the public?

Michael McCoy (MM): I think there's a distinction that needs to be made first. A lot of folks have believed that research is what will drive the acceptance of acupuncture and Oriental medicine in this country. While it's helpful, I don't think it's driving it at all. In fact, I think it's following the trend. What we find is that when AOM becomes more prevalent in all of its modalities, part of the curiosity of the learned public and the lay public is to know more about it. At the same time that we've seen an increase or uptick in research on the scholarly level, we've also seen a dramatic surge in popular press publications about acupuncture. We happen to track those in my office. Just over the last year, there's been about a 35 percent increase in the number of investigative and supportive stories about acupuncture and Oriental medicine. Sometimes it's about acupuncture, sometimes it's herbs, sometime's it's tai chi or qigong or these other things. There's been a dramatic increase because people are more interested, and researchers are more interested. This is very good, because it's part of the process of acceptance that we're going through. I think that's a wonderful thing, and something we should encourage as much we can.

That's important to the profession in general. It's also important to the acupuncturist in particular for two reasons. First, it means the likelihood is that there will be more and more patients out there. Second, it provides a foundation in the accessible language for our practitioners, if they continue the habit of lifelong study, to continue to enhance their skills and knowledge, which is another thing that's very important.

AT: We've noticed that while research on acupuncture and Oriental medicine has been on the rise, other forms of alternative medicine, such as chiropractic, appear to be declining. Why do you think that's occurring?

MM: I think it's very clear what's going on. There is a natural curve or life cycle for the acceptance of cultural trends. Chiropractic experienced the same curve that we are on now a few years earlier. There was a phase during that when there was a dramatic upsurge in research publications about chiropractic, as it was going from a position of being marginalized in the culture to being largely accepted. That surge in research was partly driven by the efforts of some to discredit it, partly driven by the efforts of others to demonstrate its value, and partly driven by the broad curiosity that all kinds of folks had about whether it was a valid way of thinking about health care. As chiropractic moved into broader public acceptance, those questions were no longer burning as they once had been.

We're a little behind that curve. We're in the process where suddenly this new awareness is coming to pass, and there's burning curiosity about it.Ê Massage is not as new or as dramatic in its move from the fringe to the center. It's largely accepted, although it's been largely misinterpreted and misunderstood. I think we'll see a small bump in its research as people begin to think of it as not something to do with general comfort, but something that can significantly improve their well-being. I see a similar bump in research for naturopathic medicine, which I think is just a little behind us on the curve. There may be others behind that; it will be interesting to see what happens.

AT: There also has been a lot of action taking place on a legislative basis. South Carolina passed an acupuncture licensing bill recently; Kentucky has pre-filed an acupuncture bill for this year; and Rep. Hinchey has the Federal Acupuncture Coverage Act. What is the Alliance's position on these laws? What about improving or increasing scope of practice in states that already have licensing laws?

MM: The Alliance's position is that appropriate practice legislation is very important. We're very pleased with what has happened in South Carolina. We have been major participants in the work in Kentucky. I helped the Kentucky Society of Acupuncture organize in the first place, and we've worked very closely with them. We have other initiatives going on in Mississippi and Puerto Rico. We care a great deal about this. We think that practice regulation is very important. It protects the public, it protects the practitioner and it ensures that the public has access to good health care as provided by AOM.

We also were the first national organization to endorse the Federal Acupuncture Coverage Act of 2005. I worked very hard with my colleagues in the leadership positions of other organizations. Virtually every other national organization has joined us in this effort. I don't mean to claim any primacy there, except to say that I think the Alliance hired me in part because I once was a lobbyist, and I know something about how to influence public policy. They have encouraged me to get involved, and I have been trying to build partnerships that will move forward on all of these fronts.

As to whether there needs to be a broadening of scope of practice or, as I would prefer to call it, appropriate definition of scope of practice in a number of states, the answer is, absolutely. We have now a hodgepodge of different laws in different states, which really is a barrier to portability of licensure from one state to another. I think we need to move toward a system that will bring all of the scope of practice laws into some rough uniformity. There's no need for them to be identical, but if we at least get them all to about the same appropriate level, then we'll find that the portability question of licensure is very easy. Any number of problems would go away if we could begin to bring these laws into some closer connection with one another. We're working on that.

It's not as romantic or sexy a business to tinker with these laws as it is to get the first one passed. There is a lot more publicity when you get a new bill passed in South Carolina or Kentucky than there is when you get a clause stricken or added in New York.

AT: But it's still important.

MM: It's just as important, or perhaps more.

AT: With regard to all of the different issues we've been talking about, each year, we run a poll on acupuncturetoday.com asking our readers to indicate what they feel is the most important issue facing the profession in the coming year. The issue has changed each year. One year, it's increased research; the next year, it's increased educational standards or greater cooperation between the national organizations. What do you think this says about the profession?

MM: I think it says we're on the move. I think it says that people respond to the polls that they read in Acupuncture Today and try to do something about those issues. I can give you an example. One of the issues that came up recently, and was mentioned in your question, is a need for greater cooperation among the national organizations. I know that a very strong part of my mandate has been to work closely with all of the national organizations, in particular with the AAOM. I've reached out to them and to Will Morris, and have discovered that they are reaching out to us as well.

I think we listen to what people want, and we're trying to build all kinds of bridges and partnerships. When the Kentucky issue first arose, one of the first things I did was to call Rebekah Christensen and Will Morris and ask them if they wanted to help us out - and they did. So, I think we listen to these polls so that issues get improved a bit and we can move on to something else. I think we can also look at the sequence of issues that have been important and recognize the process and progress of the profession as it gains acceptance and credibility within the broader culture.

AT: Where do you see this profession in five years? Ten years?

MM: Now we have another of those answers that's much more personal to me than it is a matter of policy from the Alliance, so I can only answer it that way. I believe that we are in the early phases of a dramatic curve of acceptance for AOM. I think many of the debates that we've seen over the last few years are growing pains. I believe that we'll see the doctorate established very quickly and become very popular. I believe we'll see it becoming a diversified doctorate with different strands as we discussed earlier, and I think we'll see dramatic acceptance of AOM by the culture so that there will be more patients and that practitioners will find their income levels becoming much more satisfactory. I also believe that those who are speaking of a transformation in the American health care system are generally on target and that it's very hard to predict what most practitioners' lives will look like as this transition unfurls. My guess is that a small percentage of our practitioners will be wearing lab coats and look like traditional Western doctors, and will be practicing in conjunction and collaboration with them. My guess is that we will continue to see the vast majority of our folks operating more and more independently, in many cases as primary practitioners in their own rights, caring for their own folks and referring to Western medicine where they deem it appropriate. But I believe that we will see in the next 5-10 years a dramatic increase in the number of acupuncturists, and an even more dramatic increase in the number of patients.

I should add that I'm afraid I don't see the current compensation system as tenable. I think that our insurance-driven system will collapse.

AT: What type of system will replace it?

MM: I imagine that we'll see a system more like what goes on in Canada or Great Britain, where the government provides a basic level of health care, and one can augment it according to one's own resources. I'm quite convinced that governmental basic health care will include AOM. I think the day is coming where you will have a national health care card, or something of that sort, and that you will be able to take that to your acupuncturist, who will render certain services if the acupuncturist chooses, and be compensated by the government at a reasonable rate.

I haven't said whether I approve of this transition. I don't think it's something that is subject to my approval or not, but I think it's going to happen. It has happened in most of the other Western countries. It will be interesting to see. And I believe this is driven not by issues having to do with people's interests or their political philosophy. I think it's going to be driven by dollars and cents.

AT: And the Alliance? Where will it be in five or 10 years?

MM: The Alliance has been going through its own little identity crisis. When I came to the Allliance, it was very self-consciously an organization of advocates for professionals, and it was struggling with why it should do that when there was another organization that was doing that, and they didn't agree on the best way to advocate for professionals. I think the Alliance has come through a process of realizing that the best way it can advocate for the professional in many ways is to advocate for AOM as a whole. So, it is moving into the recognition that there's important work that needs to be done and is not being done in areas of consumer education, in areas of changing public acceptance, and it's working in those areas. The change of approach has been part of what's enabled us to work more closely with a lot of other organizations, including all of the main national organizations. We recognize now that we're not competing with anybody. We're doing what we're doing; they're doing what they're doing; and if we all work together, a lot can happen.

I see that process continuing. The Alliance is rapidly gaining professional members now. Folks ask me all the time if they should join the Alliance or the AAOM. My answer is very simple - please join both. To encourage them to join both, if they tell me that they're going to join the AAOM, I will make their Alliance membership less expensive. We do that because we want them to support both, and the profession and practitioners need to support both sets of activities. Having said that, I think we will also see a dramatic impact from our consumer arm. We are signing up consumer members in droves. Their membership is very inexpensive, and they get something quite different from us, but they are the key to building public acceptance of AOM in the whole culture. It's not just about the practitioner. We are really about public health.

AT: Any other comments you would like to add, or anything you would like to say to our readers?

MM: I've thought about that, and I do have one thing to say. I came into this community really as an outsider just a couple of years ago. I found a profession full of people who share some common traits, and I think we don't recognize and celebrate those traits enough, because the practitioners of AOM are underpaid, overworked, overburdened with debt - and yet, they do it anyway. What has drawn me to this work and given me a passion for it is the dedication of our healers to relate to their patients and improve their health. This is a fine profession, and it will receive the praise and glory that it deserves, and the economic rewards, but what I think will reward us most is the satisfaction of that altruistic impulse that I see everywhere - among the leaders, among the practitioners, among the whole AOM community, and that's why I'm proud to be a part of it.

AT: Thank you.