AAAOM: Facing An Ultimatum

Editor's Note: This is part of a series looking into the inner workings of the AAAOM. Read Part I, Part II.

On the heels of the growing discontent with leaders of the AAAOM, the Council of State Associations (CSA) recently took it upon themselves to present the organization with an ultimatum: for all board members to resign from the board and turn the organization over to the CSA or they will proceed on their own to become the primary representative of the AOM profession.

The CSA Chair and Vice-Chair presented this ultimatum at the AOM Leaders (AOML) meeting hosted in Columbia, Maryland by CCAOM (Council of Colleges of Acupuncture and Oriental Medicine) on March 21. Leaders met to let AAAOM leaders, specifically president Michael Jabbour and acting president Joshua Saul know that AAAOM remains ineffective and change is needed. The board was given 10 business days from the meeting to resign (as of press time, the timeline was not complete). The association's history of the dysfunction and lack of leadership were noted by various state organizations.

In the midst of the CSA uproar, Jabbour has continued to appoint new members to the AAAOM board following the Maryland meeting. Newly absent, (by choice or by removal is unclear), from the board 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 added three of the six names of the most recent nominees Donnell Borash, Nicholas Haridopolos and Don Lee.Two new board members, Dr. Carlos Chapa, DOM, Lac, PhD and Dominic Sembello, Lac, Dipl. Ac., were recently appointed without notice. Both are reportedly current members of the National Guild of Acupuncture and Oriental Medicine.

Michael Jabbour is still listed as the AAAOM president despite stating his term was up in an interview with Acupuncture Today and despite a written statement made during the AOM meeting in which he stated "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 two weeks." Not coincidentally, it is reported that he recently joined the National Guild.

That brings the total number of Guild members on the AAAOM board to four out of the 11 filled positions, as AAAOM director Andy Rosenfarb is a Guild Vice President. When asked earlier 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.

To understand how the CSA came to its recent stance, a look back at a 2012 Chicago meeting paints a painful picture.

The Chicago Implosion

In 2011, Renata Rafferty, an independent consultant reportedly hired by Jabbour, was hired by the AAAOM to lead various planning and training sessions for the AAAOM and the CSA. In 2012, after a year of facilitating planning and training sessions, as well as participating in numerous conference calls and meetings with board members and board leaders, Rafferty was asked to conduct the 2012 Annual Meeting in Chicago.

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.

In the year leading to the Chicago meeting, 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, Rafferty walked away disappointed and the open dialogue led to disagreements and disillusioned members.

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 heeding 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.

"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."

With so many board member resignations, 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.

As of press time, a total of eight board members have resigned in the last two years with an additional nominee declining to be sworn in. The most recent, Cynthia Clark and Michelle Louiselle were "non-compete" nominees and 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.

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. In a statement published on their website, the AAAOM leaders insist that "there were more open seats than actual candidates."

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."

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. According to 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 number of current professional and joint members (520 total) only 27 members are required to elect board members and change the bylaws. 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 for his livelihood 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.

A recent Acupuncture Today poll 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.

Competing Organizations?

Anticipating that their ultimatum will be rejected, Tracy Soltesz, chair of the CSA, believes they have the answer: "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."

According to various state associations, the CSA's specific plans for change are as follows: Members would join one organization, via their state group(s) and simultaneously gain membership in the national association.

State association members elect their own board of directors and those boards select two representatives to sit on a national governance council. Through this council, each state has an equal opportunity to express its needs in a federation, senate-style environment. States can share expertise, experience and information. They also remain completely autonomous in crafting and implementing policy within their own state.

The senate-style council forms national policy, informed by the "on-the-ground" realities expressed by members in each state. This council would elect an executive board to coordinate representation of the profession at the national and international levels. It would also carry out the core fiduciary duties of the larger association. The senate-style group would vet candidates for these positions, ensuring that those who step up are able and committed to the job, according to the outlined plan sent out by various state organizations.

Soltesz declined to offer any further comment, stating that the CCAOM, the hosts of the AOML meeting, will be providing a joint press release on behalf of all the attending organizations. That press release is expected on April 4 (after our press deadline - please visit acupuncturetoday.com for the update to this article).

Editor's Note: Acupuncture Today is closely following the developments of this CSA outcome, for updates and the latest information, visit acupuncturetoday.com. Please see all Supporting Documentation and References at www.acupuncturetoday.com/aaaom.