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.
Leadership and Service: An Interview With AAOM President Will Morris, LAc, OMD, MSEd
In October 2004, Dr. Will Morris was elected to serve as president of the American Association of Oriental Medicine, replacing Dr. Gene Bruno, who had served as the AAOM's president from 2002 to 2004. In the year since his election, Dr. Morris has been instrumental in helping to shape the direction of the AAOM - and, in many ways, the direction of the acupuncture and Oriental medicine profession.
In this exclusive two-part interview with Acupuncture Today, Dr. Morris reveals his thoughts on a variety of issues he feels are of importance to the success of the profession. Among the topics discussed are the development of a doctoral program, the impact CPT codes will have on the practice of acupuncture, and the Federal Acupuncture Coverage Act.
Acupuncture Today (AT): How have things gone in your first year as president?
Will Morris (WM): First, let me say that it's an honor and a privilege to serve, and that leadership is very much about service. My expectations of that first year have in many ways been met and exceeded. We have reconstructed our mission statement to read "to promote excellence and integrity in the professional practice of acupuncture and Oriental medicine." We were formed in 1981 to be a unifying force for American acupuncturists and practitioners of Oriental medicine, and I think we're moving in that direction. The AAOM has had a number of successful collaborations at the state level, not just here in California, where I live, but also in a number of venues throughout the country, notably South Carolina, where they managed to get a law through that's free of any physician referral requirements. We continue to support Michigan in that area, as well as New Jersey. Our long-term goal is the independent practice of acupuncture and Oriental medicine by professional providers of acupuncture and Oriental medicine in every state, with a scope that is representative of the full range of practice of acupuncture and Oriental medicine.
AT: What has been your most significant accomplished to date?
WM: There are so many accomplishments. I believe that our conference track is getting on the beam. One of the things that we have to look at, and that any professional association has to look at, is core business. Our core business is service to our membership, and there are primary domains of influence with respect to that which have to do with protecting access to the materials of our trade. We have ongoing relationships with the FDA and connections to the Department of Health and Human Services with respect to protecting our access to the materials of our profession, such as ma huang. Other areas include education, and to that end, we have participated extensively with the Accreditation Commission's task force for the development of a doctoral program that's a first professional degree. I believe that the products that are coming out of there are exemplary. They need refinement and some more work, and certainly that area is absolutely the purview of ACAOM. However, historically, there has always been an influence of the profession on the development of the standards for education, and we continue to stand by that in partnership with ACAOM and the Council of Colleges - and also in partnership with FAOMRA, because they are involved in the application of the legal statues in every state for the practice of acupuncture and Oriental medicine. All of these are important collaborative efforts to improve the stature of acupuncture and Oriental medicine as it is practiced in North America.
AT: What is the AAOM's opinion of the doctoral program? Is it necessary for the profession, or is it more of an issue of status? Also, what is the AAOM's opinion of the National Oriental Medicine Accreditation Agency (NOMAA) and its doctoral program compared to ACAOM's program?
WM: That's a whole bunch of questions bundled up into one. Let me try and unpack it a little bit.
First, I personally believe that the entry-level should be a doctorate. That's my personal belief. The surveys we have conducted show that about 70 percent of the population is interested in the doctorate as a first professional degree. I happen to know that ACAOM's survey of the country showed about a 50-50 split. However, that study did not penetrate the Asian community in California. I can say that I've done unstructured interviews with practitioners and leaders in the Southern California Chinese community and with those professional associations, and unequivocally, they desire a doctorate as a first professional degree. For whatever reason, the ACAOM studies did not penetrate that population, so to the best that I can tell, we're really looking at about 70 percent preference nationwide for a doctorate for the first professional degree. We at the AAOM follow the lead of our membership on that.
What we can say is this. First of all, if a person enters a program with a baccalaureate degree, a master's degree, which is four-year program at 3,000 hours, becomes the longest master's program in history. As a first professional degree, it would really do well to be titled as a doctorate, with maybe a few of the competencies that are being newly articulated through the Institute of Medicine and are now reflected in the ACAOM standards, such as "evidence-based practices." I know this is a buzzword that leads people to hesitate, and we do have evidence - we use historical evidence to base our practice on. But we do need contemporary evidence, and we need to compile best practices to reach reasonable clinical decisions as professionals. This becomes an area of competency. It's important to get our new learners exposed to these types of thinking, and also the critical thinking and methodology necessary to develop best patient care models. So there are a number of issues that are of concern.
Most notably, the new environment that practitioners will find themselves in will demand new sets of skills. Our practitioners are no longer just going into private practices, but as we grow in this culture, the demand for hospitalists, researchers, and practitioners with the capacity to provide care in multidisciplinary settings is increasing. We need to develop educational systems that prepare these people for those environments, and that is necessarily the doctorate. If we look at and compare ourselves to any of the other primary care health providers or other providers within the networks of care, they are all moving toward the doctorate. So, I think it's reasonable to think that this is an appropriate thing to do.
When it comes to the NOMAA program, while I have seen a list of courses, I have not seen a sufficient set of criteria that have been developed to a degree that it's possible to comment. Besides speculating on the schools that may have received NOMAA approval, I get confused when I hear accreditation, because that implies a certain level of authority within the culture that remains to be seen at this point.
Here's what I have to say, though. If ACAOM - and this comes from my interpretation of statements made by the Chinese community in Southern California - is not able to put a doctorate together, with the title of "Doctor of Oriental Medicine," I believe there are sufficient resources within the Chinese community to continue to sustain support for NOMAA such that the degree title and entry-level stature that that community desires will be achieved. However, if ACAOM can deliver a doctorate in a timely fashion, with the kinds of titles that are being requested from the field at large, particularly the Asian community, the question of a second accrediting agency in our field of medicine may be a mute point, in my estimation.
AT: In other words, if ACAOM doesn't move forward or won't move forward, the Asian community will support an organization that does and will.
WM: Right. It's fairly simple. But let's be very clear. At this stage, the AAOM sees ACAOM as an accrediting body with a substantial track record, standing with the DOE, and performing high-quality accreditation, particularly with the new commissioner lineup that they have. I believe they're functioning at a level that they never achieved in the past, and we support that. We support anything that promotes the high quality of education in acupuncture and Oriental medicine that will permit this field to succeed within this culture.
AT: What has been CCAOM's stance on the doctoral program? We have seen instances in which representatives of a college appear to be against increases in educational hours, but in order for a school to offer a doctoral program, you would almost expect an increase in educational hours to happen. Do you know definitively if the Council is in favor of a doctoral program?
WM: Well, there are different messages that come from the CCAOM. You have more than 50 schools involved, and you have schools that are offering doctorates and schools that aren't. You have start-up schools with very few students. The range of needs that comes from the Council is extensive.
AT: And there are other issues, such as use of the doctor title in certain states.
WM: Right. This becomes another concern. It's not just the size and capacity of each of the institutions, but also the legal climates in which they function. So of course CCAOM's concern is that these institutions are not harmed in the development of new standards. But a professional association's concern is the highest standards that permit the best quality, and this is always a question we face. What degree of training is necessary to achieve an optimal entry level? At the professional level, we're not concerned just with safety as is a state licensing board or certification agency. Their purview is the safety of the public. The professional association is concerned with the success of the professional. And it requires a certain degree of training that is above safety in order to ensure a competency level that garners success. Of course, safety is subsumed as the minimal standard for licensure. Our concern is more than safety, because if the practitioner is trained to the level of competency, and they're able to succeed, what that means is that the patient receives better care, and it becomes a more economical course of care.
AT: You had mentioned the AAOM's conference track has improved. Tell us about that and how it relates to the association's annual meeting.
WM: This promises to be one of AAOM's best conferences ever. It's at the Chicago Westin; people can find out more about it on the AAOM Web site (www.aaom.org).
I believe in process, and one of the things that the AAOM board of directors and our conference chair, Deborah Lincoln, have done is to raise the bar on our abstract submission process for speakers. We invite anyone who's interested in speaking to submit an abstract now, either for next year or the year after. We want to get new people. A new person on the scene is Ray Rubio, who studied quite a bit with Dr. John Shen, and is a specialist in reproductive endocrinology, and is doing remarkable work. Ray is a brilliant practitioner. His presentation will be deep and thorough.
We're really looking for rising stars to be able to present, along with those people who have already established themselves in the speaking area for acupuncture and Oriental medicine, such as Jeffrey Yuen and Miki Shima. I'm looking forward to hearing both of them speak.
Returning to process, I'm a big fan of it. So, the abstract submission system is very thorough in that it goes to the conference committee for review. What we're doing is modeling major university methodologies for conducting conferences and presentations.