AOMA President's Blog

Modulatory effects of acupuncture on resting-state networks: A functional MRI study combining independent component analysis and multivariate granger causality analysis†

2012-01-04T00:05:00.000-08:00

Further exploration of brain - acupuncture connection with magnetic resonance imaging
http://onlinelibrary.wiley.com/doi/10.1002/jmri.22887/abstract
Researchers reported: "Following acupuncture at GB40, the strength of causal connectivity between the superior temporal gyrus (STG) and anterior insula was enhanced, while the connection strength between the STG and postcentral gyrus increased following acupuncture at KI3. Additionally, the causal influences within the auditory network increased following acupuncture at GB40, in comparison with the executive network following acupuncture at KI3."

Chongguang Zhong PhD¹,
Lijun Bai PhD^1,†,
Ruwei Dai PhD¹,
Ting Xue PhD²,
Hu Wang PhD¹,
Yuanyuan Feng PhD¹,
Zhenyu Liu PhD¹,
Youbo You PhD¹,
Shangjie Chen PhD³,
Jie Tian PhD^1,2,*

Comment NOW on Acupuncture for the Affordable Care Act

2011-12-17T04:40:00.000-08:00

News Release
FOR IMMEDIATE RELEASE
December 16, 2011

Contact: HHS Press Office
(202) 690-6343

HHS to give states more flexibility to implement health reform
Approach will help ensure consumers have quality, affordable coverage
starting in 2014

The Department of Health and Human Services today released a bulletin
outlining proposed policies that will give states more flexibility and
freedom to implement the Affordable Care Act.

The Affordable Care Act ensures all Americans have access to quality,
affordable health insurance. To achieve this goal, the law ensures
that health insurance plans offered in the individual and small group
markets, both inside and outside of the Affordable Insurance Exchanges
(Exchanges), offer a comprehensive package of items and services,
known as “essential health benefits.”

The bulletin released today describes an inclusive, affordable and
flexible proposal and informs stakeholders about the approach that HHS
intends to pursue in rulemaking to define essential health benefits.
HHS is releasing this intended approach to give consumers, states,
employers and issuers timely information as they work toward
establishing Exchanges and making decisions for 2014. This approach
was developed with significant input from the public, as well as
reports from the Department of Labor, the Institute of Medicine, and
research conducted by HHS.

“Under the Affordable Care Act, consumers and small businesses can be
confident that the insurance plans they choose and purchase will cover
a comprehensive and affordable set of health services,” said HHS
Secretary Kathleen Sebelius. “Our approach will protect consumers and
give states the flexibility to design coverage options that meet their
unique needs.”

Under the Department’s intended approach announced today, states would
have the flexibility to select an existing health plan to set the
“benchmark” for the items and services included in the essential
health benefits package. States would choose one of the following
health insurance plans as a benchmark:

One of the three largest small group plans in the state;
One of the three largest state employee health plans;
One of the three largest federal employee health plan options;
The largest HMO plan offered in the state’s commercial market.

The benefits and services included in the health insurance plan
selected by the state would be the essential health benefits package.
Plans could modify coverage within a benefit category so long as they
do not reduce the value of coverage. Consistent with the law, states
must ensure the essential health benefits package covers items and
services in at least ten categories of care, including preventive
care, emergency services, maternity care, hospital and physician
services, and prescription drugs. If a state selects a plan that does
not cover all ten categories of care, the state will have the option
to examine other benchmark insurance plans, including the Federal
Employee Health Benefits Plan, to determine the type of benefits that
will be included in the essential health benefits package.

The policy proposed today by HHS would give states the flexibility to
select a plan that would be equal in scope to the services covered by
a typical employer plan in their state. States and insurers would
retain the flexibility to evolve the benefits package with the market
as innovative plan designs are developed and advancements in care
become available, and meet the needs of their citizens.

“More than 30 million Americans who newly have insurance coverage in
2014 will have a comprehensive benefit package,” said Sherry Glied,
PhD, assistant secretary for planning and evaluation. “In addition to
assuring comprehensive coverage for the newly insured, many millions
of Americans buying their own insurance today will gain valuable new
coverage, including more than 8 million Americans who currently do not
have maternity coverage, and more than 1 million who will gain
prescription drug coverage.”

The bulletin issued today addresses only the services and items
covered by a health plan, not the cost sharing, such as deductibles,
copayments, and coinsurance. The cost-sharing features will be
addressed in future bulletins and cost-sharing rules will determine
the actuarial value of the plan.

Public input on this proposal is encouraged. Comments are due by Jan
31, 2012 and can be sent to: EssentialHealthBenefits@cms.hhs.gov.

For the essential health benefits bulletin, visit:
http://cciio.cms.gov/resources/regulations/index.html#hie

For a fact sheet on the essential health benefits bulletin, visit:
http://www.healthcare.gov/news/factsheets/2011/12/essential-health-benefits12162011a.html

For a summary of individual market coverage as it relates to essential
health benefits, visit: http://aspe.hhs.gov/health/reports/2011/IndividualMarket/ib.shtml

For information comparing benefits in small group products and state
and Federal employee plans, visit: http://aspe.hhs.gov/health/reports/2011/MarketComparison/rb.shtml

###

Note: All HHS press releases, fact sheets and other press materials
are available at http://www.hhs.gov/news.

Last revised: December 16, 2011

Is acupuncture safe for children?

2011-11-30T04:58:00.000-08:00

November 22, 2011, *11:00 am*

*Acupuncture Is Safe in Children, Study Finds*

*By **ANAHAD O'CONNOR*

Joe Raedle/Getty ImagesCan acupuncture help children?

Is acupuncture safe for children?

According to a large new study in the journal
Pediatrics<http://pediatrics.aappublications.org/>,
the short answer is yes — in the hands of a trained practitioner. The
study, the first large-scale systematic review on the safety of pediatric
acupuncture, found that about one in 10 children had experienced mild side
effects, like bruising and pain and numbness at the puncture site. More
serious side effects, like infections and nerve impairment, were rare.

AOMA President's Blog: Speaking at American Herbal Guild

2011-10-17T16:04:00.000-07:00

AOMA President's Blog: Speaking at American Herbal Guild: http://www.americanherbalistsguild.com/

Speaking at American Herbal Guild

2011-10-17T11:06:00.000-07:00

It is important for acupuncturists to be conversant in western herbal traditions as patients will self-prescribe the materials, or may have received them from other providers. Here is a ink to the American Herbal Guild where I will be speaking pulse and tongue diagnosis for western herbalists: http://www.americanherbalistsguild.com/

Proving East Asian Medicine

2011-07-01T19:29:00.000-07:00

First Published in:

Acupuncture Today
September, 2010, Vol. 11, Issue 09

Proving East Asian Medicine

By William Morris, DAOM, PhD, LAc

East Asian medical research focuses on quantitative means of proof. This affects the information obtained, thus what become considered best practices. I maintain that the world of East Asian medicine might also be understood through qualitative means.

Quantitative Research
The traditional scientific approach to research has its underpinnings in what is called positivist philosophy. As a paradigm, positivists consider that true knowledge is scientific and measurable. The methods of positivism are informed by a set of principles including:
Value-freedom. Human beliefs and interests should not influence the choice of what and how to study a problem. Rather, it should be determined by objective criteria.
Causality. Research should identify causal explanations and fundamental laws.
Operationalization. The methods should enable facts to be measured quantitatively.
Independence. The researcher is independent of the subject.
Reductionism. Problems are better understood if they are reduced to the simplest possible elements.

Qualitative Research
Qualitative researchers consider that human beliefs and interest form the bedrock of decisions about what should be researched. The focus upon fundamental laws creates general information, and causes may change when applied to the individual human being. Qualitative methods of capturing information can often provide rich depth compared to quantitative. Regarding independence, qualitative research represents the researchers’ participation in, and influence upon, research and its outcomes. For Chinese medicine, which is a model of care that embraces complex systems and conditions, reductionism might miss the point.

In the hierarchical scheme of knowledge for evidence-based medicine, the randomized controlled trial sits at the top of the pyramid. This comes from a positivist point of view and does have value. The application of pharmaceutical treatments and population studies for risk-benefit assessment make the randomized controlled trial vital.

The extension of the resulting assumptions into social systems and individual lives poses a problem, however. Speaking about the world of human experience requires an extensive commitment in terms of time and dedication to process. However, this world is often dismissed as subjective and regarded with suspicion. Small qualitative studies are not generalizable in the traditional sense, yet have redeeming qualities that set them above that requirement.

Qualitative research investigates the why, not the how. Often, data is unstructured and can involve interview transcripts, e-mails, notes, feedback forms, photos and videos. Qualitative data can be used to gain insight into people’s attitudes, behaviors, value systems, concerns, motivations, aspirations, culture or lifestyles. Here, I will present six methods of qualitative research including case study, grounded theory, phenomenology, ethnography, narrative methods and historical research. Last, I will briefly present models for mixing qualitative and quantitative methods.

Case-study research is a form of qualitative descriptive research that looks intensely at an individual or small participant pool, drawing conclusions only about that participant or group and only in that specific context. Researchers do not focus on the discovery of a universal, generalizable truth, nor do they typically look for cause-effect relationships. Instead, emphasis is placed on exploration and description. Developing a case study involves gathering all the data, organizing it into an approach to highlight the focus of the study. Then, a case study narrative is developed. The narrative might be validated by review from program participants. Further, a case study series might be cross-compared to isolate any themes or patterns. The writings of Robert Stake and Robert Yin should be seriously considered by anyone wishing to employ case studies and case series in their graduate work.^1-4

Grounded theory is a systematic generation of theory from data. Rather than beginning with a hypothesis, the first step is to collect data via qualitative or quantitative means. Key points are identified in the data and marked with codes and grouped into categories which become the basis for the development of theories and reverse-engineered hypotheses. Grounded theory is gaining strength in the area of medical research and there are medical research projects receiving funds from the NIH.^5,6

Phenomenology involves describing the structures of experience as they present themselves to consciousness, without recourse to theory, deduction, or assumptions from other disciplines. Phenomenology studies the structures of consciousness as experienced from the first-person point of view. The central structure of an experience is its intentionality, being directed toward something, as it is an experience of or about some object. An experience is directed toward an object by virtue of its content or meaning (which represents the object) together with appropriate enabling conditions.^7-9

Ethnography is a form of research focusing on creating meaning through close field observation of sociocultural phenomena. Typically, the ethnographer focuses on a community that may occur geographically or in cyberspace, They may be practitioner groups, patient groups and provider networks. From these groups, informants are selected who are known to have an overview of the activities of the community. Such informants are asked to identify other informants representative of the community, using chain sampling to obtain a saturation of informants in all empirical areas of investigation. Informants are interviewed multiple times, using information from previous informants to elicit clarification and deeper responses upon re-interview. This process is intended to reveal common cultural understandings related to the phenomena under study.^10-12

Historical research involves the systematic collection and objective evaluation of data related to past occurrences in order to test hypotheses concerning causes, effects or trends of these events that may help to explain present events and anticipate future events.¹³ Historical research involves developing an understanding of the past through the examination and interpretation of artifacts such as texts, physical remains of historic sites, recorded data, pictures, maps recordings and other forms of evidence. The historian’s job is to find evidence, analyze its content and biases, corroborate it with other evidence, and use the evidence to develop an interpretation of past events that has some importance for the present. Historians use libraries to locate primary sources (firsthand information such as diaries, letters and original documents) for evidence find secondary sources, historians’ interpretations and analyses of historical evidence verify factual material as inconsistencies arise.

Narrative research methods involve the researchers collecting and telling stories about people’s lives, and writing narratives of individual experiences. As a distinct form of qualitative research, a narrative typically focuses on studying a single person, gathering data through the collection of stories, reporting individual experiences, and discussing the meaning of those experiences for the individual.

Mixed-methods research provides for quantitative and qualitative points of view to be used simultaneously. Mixed methods research refers to methods, design and philosophical assumptions. There is a good deal of discussion about philosophical assumptions that guide the direction of the collection and analysis of data.¹⁴

There are other forms of qualitative inquiry. The ones I presented here are representative of more common methods and applications. I hope that the tools presented here can further the dialog.
References

Yin R. Applications of Case Study Research. Thousand Oaks, Calif.: Sage, 2003.
Yin R. Case Study Research: Design and Methods. Thousand Oaks, Calif: Sage, 2002.
Stake R. The Art of Case Study Research. Thousand Oaks, Calif.: Sage, 1995.
Stake R. Multiple Case Study Analysis. New York: Guilford Press, 2006.
Glaser BG, Strauss A. Discovery of Grounded Theory. Strategies for Qualitative Research. Edison, N.J.: Aldine Transaction, 1967.
Bryant A, Charmaz K, eds. The Sage Handbook of Grounded Theory. In: The SAGE Handbook of Qualitative Research. Thousand Oaks, Calif: Sage Publications, 2007.
Merleau-Ponty M. Phenomenology of Perception. New York: Routledge, 1962.
Husserl E. Ideas Pertaining to a Pure Phenomenology and to a Phenomenological Philosophy. Boston: Kluwer Academic Publishers, 1991.
Moustakas C. Phenomenological Research Methods. Thousand Oaks, Calif.: Sage Publications, 1994.
Denzin NK. Interpretive Ethnography: Ethnographic Practices for the 21st Century. Thousand Oaks, Calif.: Sage Publications, Inc, 1996.
Denzin NK. Interpretive ethnography for the next century. J Contemp Ethnography Oct 1, 1999;28(5):510-9.
Heivilin D, MacColl G, Jackson E, Edwards T. Federal Programs: Ethnographic Studies Can Inform Agencies’ Actions. www.gao.gov/cgi-bin/getrpt?GAO-03-455.
Gay LR. Educational Research. Competencies For Analysis and Application. Prentice-Hall, Inc., 1996.
Clark VLP, Creswell JW. The Mixed Methods Reader. Thousand Oaks, Calif.: Sage Publications, 2008.

Military Does Acupuncture for PTSD

2010-06-20T08:31:00.000-07:00

http://www.statesman.com/news/local/military-tries-acupuncture-to-treat-troops-for-ptsd-757786.html

Clean Needles for Acupuncture Safety

2010-06-10T19:38:00.000-07:00

First Published in Acupuncture Today
June, 2010, Vol. 11, Issue 06

By Michael Jabbour, MS, LAc, William Morris, DAOM, PhD, LAc and Steven Schram, PhD, DC, LAc

A recent article in the British Medical Journal by Woo et al. argues that infection from acupuncture needles is a serious problem.¹ Pointing at 50 cases worldwide since 1970, the author implies that acupuncture is dangerous because the risk of infection is high and that acupuncturists are not using sufficient care to prevent infections.

Consider the facts in context. There are currently 30,000 acupuncturists and 8,000 acupuncture students in the U.S. Each sees an average of 50 patients per week. This equates to roughly 1.5 million treatments per week and 78 million acupuncture treatments per year. This does not include the multitude of acupuncturists in Europe, Australia or the Far East, where acupuncture is routinely practiced and, in main cases, fully integrated into mainstream medicine and government-reimbursed health care. The claim of 50 disparate infections worldwide over a 40-year period comes to approximately one infection per year globally. If anything, this article highlights the extraordinary safety of acupuncture treatments, not that acupuncture presents a danger to the public. Given the billions of acupuncture treatments administered worldwide, it is clear that there is an extremely low risk of infection from acupuncture needle insertion.

If these same low levels of adverse events were reported for any treatment method in conventional medical practice, that treatment would rightly and routinely be touted as a huge success. With regard to mainstream medical practice, an average of 195,000 people in the U.S. died due to potentially preventable, in-hospital medical errors from 2000 to 2002, according to a new study of 37 million patient records that was released by HealthGrades, the health care quality company.³ In addition to the deaths, 1.14 million patients also suffered a "safety incident," which represents one in four Medicare patients admitted from 2000 to 2002.⁴

Another risk gauge for infection or other side effects in acupuncture is the cost of malpractice insurance. A $1 million to $3 million policy for an acupuncturist in the U.S. is less than $800/year. If there was an infection risk of any magnitude, the premiums would be significantly higher.
According to Adrian White, clinical research fellow at the Peninsula Medical School, and Mike Cummings, both editors of Acupuncture in Medicine, the risks associated with acupuncture can be considered negligible in the hands of competent practitioners.^5-7 In fact, White and Cummings go further to say that the currently published opinion of medical experts is that routine disinfection of skin prior to needle insertion is actually unnecessary in healthy patients, even though it is regularly practiced in acupuncture clinics in the U.S.^8,9

Woo's second claim that acupuncturists are not using sufficient care to prevent infections is also not factual. Without current best acupuncture practices, Woo states that the cause of most outbreaks was from "improperly sterilized reusable acupuncture needles." But he fails to mention the fact that qualified acupuncturists in the U.S., Canada, the U.K., and many other countries must adhere to strict clean-needle guidelines and, by law, may only use sterile, single-use disposable needles.¹⁰ In fact, the article fails to cite research published in the same journal showing acupuncture to be extremely safe when practiced by a trained acupuncturist.⁶

The Woo article errs on two counts. It sensationalizes negligible risk and omits current best practices that mitigate what little risk is, in fact, there. Additionally, Woo's analysis undermines the scientific and regulatory integrity of the profession, clearly pointing to academic bias. What would be more appropriate and useful to health care providers and the public is recent data taken from prospective studies of the incidence of infection from acupuncture.^11,12 This would place the risk associated with acupuncture treatment delivered in the U.S., U.K., and Europe in true perspective.

It is perplexing to the academic community how this irrelevant and misleading editorial was allowed through the BMJ's rigorous editorial process. The publication of inaccurate and alarmist data that does not consider current safety precautions is ill-conceived and irresponsible on the part of the author and the publisher. The article created the impression that acupuncture may be dangerous, while in fact, the readily available data shows extraordinary safety compared to many other medical interventions. The subsequent dissemination of this editorial via the BBC Web site and other news outlets raises disproportionate concern and fear mongering regarding one of the safest of the medical practices.

The reach of this inaccurate article continues worldwide. It is being republished on the BBC, Reuters, FOX News, and a growing number of other news organizations. This misinformation could lead to unnecessary panic and people choosing not to use this safe and effective treatment modality. An immediate public statement of clarification by the BMJ is warranted to preserve its reputation and give a balanced, accurate representation of factual medical information.

All authors of this article are members of the American Association of Acupuncture and Oriental Medicine (AAAOM) and active contributors to the community through academic, research, professional, legislative and regulatory work. One of the primary purposes of the AAAOM is to promote adherence to high ethical, safety, and professional standards on part of the practitioner. The AAAOM works with a wide range of national and international standards-setting and research organizations, legislative and regulatory bodies, and institutions that oversee, govern, and advance the practice of acupuncture and Oriental medicine. The AAAOM takes patient risks associated with acupuncture seriously and works to advance the practice of acupuncture and Oriental medicine in the safest ways possible.

References

Woo PCY, Lin AWC, Lau SKP, Yuen KY. Acupuncture transmitted infections. BMJ 2010;340:c1268.
Ernst E, White AR. Prospective studies of the safety of acupuncture: a systematic review. Am J Med 2001;110:481-5.
www.medicalnewstoday.com/articles/11856.php.
www.whale.to/a/iatrogenic_q.html.
White A, Hayhoe S, Hart A, et al. Adverse events following acupuncture: prospective survey of 32 000 consultations with doctors and physiotherapists. BMJ 2001;323(7311):485-6.
MacPherson H, Thomas K, Walters S, et al. The York acupuncture safety study: prospective survey of 34 000 treatments by traditional acupuncturists. BMJ 2001;323(7311):486-7.
Witt CM, Pach D, Brinkhaus B, et al. Safety of acupuncture: results of a prospective observational study with 229,230 patients and introduction of a medical information and consent form. Forsch Komplementmed 2009;16(2):91-7.
Walsh B. Control of infection in acupuncture. Acupunct Med 2001;19(2):109-11
Hoffman P. Skin disinfection and acupuncture. Acupunct Med 2001;19(2):112-6.
www.ccaom.org/cntprogram.asp.
White A. The safety of acupuncture; evidence from the UK. Acupunct Med 2006;24(Suppl):S53-7.
Witt CM, et al. Efficacy, effectiveness, safety and costs of acupuncture for chronic pain; results of a large research initiative. Acupunct Med 2006;24(suppl):S33-9.

Michael Jabbour speaks on technology, medicine and politics pertaining to traditional Chinese medicine. He is one of the founding directors of the New York State Acupuncture Coalition and the current president of the Acupuncture Society of New York, and chairs the AAAOM Medical Integration committee. He maintains a private acupuncture and herbology practice in midtown Manhattan.

Click here for more information about William Morris, DAOM, PhD, LAc.

Dr. Steven Schram has been a licensed acupuncturist since 1996. He is the past president of the Acupuncture Society of New York, and is the current president of the Manhattan District of the NY State Chiropractic Association. In addition, he serves on the Insurance Committee of the AAAOM, remains a member in the States President's Council of the AAAOM, and has maintained a private practice in Manhattan since 1984.

AOMA President's Blog: Adenosine Triphosphate (ATP) and Acupuncture?

2010-03-16T05:46:00.000-07:00

AOMA President's Blog: Adenosine Triphosphate (ATP) and Acupuncture?

Adenosine Triphosphate (ATP) and Acupuncture?

2010-03-16T05:45:00.000-07:00

Link To Audio File of the Interview

R. Douglas Fields interviews Geoffrey Burnstock of the University College London at an international meeting in Fukuoka. They discuss a new biological hypothesis for the action of acupuncture using ATP.

P2x3 respond. to ATP reacts to nerve signals interneurons go to the brain stem which has the motor neurons for organic function in digestion and respiration there are relay stations in the cortex for pain. Apparently, ATP is released in the presence of acupuncture needles.

Further Reading

Burnstock, G. (2009) Acupuncture: a novel hypothesis for the involvement of purinergic signaling. Med. Hypotheses, October, 74:470-2.

Fields, R.D. (2009) New Culprits in Chronic Pain. Scientific American November, 301: 50-57.

Fields, R.D. and Burnstock, G. (2006) Purinergic signalling in neuron-glia interactions.Nature Reviews Neuroscience June, 7(6): 423-36.

InteractionsGuide™ - Herb, Nutrient and Drug Interactions

2010-02-17T18:04:00.000-08:00

I have used this database and its variations since 1992. You might find it useful.

Warmly,

Will

InteractionsGuide™ - Herb, Nutrient and Drug Interactions

http://www.InteractionsGuide.com

Free Access during February!

Electronically Empowered Access to the Standard Reference Work in the Field:
Herb, Nutrient and Drug Interactions:
Clinical Implications and Therapeutic Strategies
Mitchell Bebel Stargrove ND, LAc
Jonathan Treasure MNIMH, AHG
Dwight L. McKee MD
MosbyElsevier 2008
932 pages

Presenting detailed, evidence-based coverage of the most commonly encountered therapeutic agents in modern clinical practice, this resource is designed to help you safely and effectively integrate herbal, nutrient, and drug therapy for your patients or clients. Combining pharmaceuticals with herbs or nutrients may complement or interfere with a drug's therapeutic action or may increase adverse effects. Drug-induced depletion of essential nutrients contribute to acute and long-terms adverse effects that are preventable through informed clinical management. Comprehensive clinical data, quick-reference features, and the insight and expertise of trusted authorities help you gain a confident understanding of how herbal remedies and nutritional supplements interact with pharmaceuticals and develop safe, individualized treatment strategies for your patients.

Key Content Features:
   * Seventy comprehensive monographs of herb-drug and nutrient-drug interactions cover the most commonly used herbs and nutrients in health-related practice and help you coordinate safe, reliable therapy.
   * Each herb and nutrient monograph features summary tables and concise, practical suggestions that provide quick and easy reference and complement the systematic review and in-depth analysis.
   * Unique icons throughout the text differentiate interactions, evidence, and clinical significance.
   * Up-to-date information keeps you current with the latest developments in pharmacology, nutrition, phytotherapy, biochemistry, genomics, oncology, hematology, naturopathic medicine, Chinese medicine, and other fields.
   * A diverse team of authoritative experts lends valuable, trans-disciplinary insight.

Instant Online Access With Powerful Database Tools Through Web Application:
   * Elegant Design – opens to summary tables and provides easy access to the depth of content that you choose.
   * Instant Full Text Search - type what you're looking for, and be taken right to it.
   * Intelligent Analysis Tool - select up to 10 substances and see the possible interactions presented according to clinical significance
   * Inline Linked Citations - view the full citations in context, and access the original abstract on pubmed with just one click.

Institutional access, multiuser accounts and academic discounts available.

Recommended by Leading Educators and Practitioners

"The most comprehensive and substantiated resource I have seen on drug/herb/nutrient interactions. I was especially impressed by Dr. Stargrove and his interdisciplinary team's ranking of the quality of the available evidence as well as their careful consideration of beneficial interactions, not just adverse effects. Required for every clinician serious about integrative medicine."

Joseph E. Pizzorno, Jr., ND

Co-founder, President Emeritus, Bastyr University, Kenmore, WA

Editor, Integrative Medicine: A Clinicians Journal

It has been well documented that many patients often do not share with their practitioners all of the medicinal products they may be using. It behooves all practitioners to not only ask patients what they are taking, but also understand potential interactions and deficiencies that might occur and make recommendations. This book, by acknowledged experts in the field of integrative medicine, offers evidence-based advise for clinicians of all types. I whole-heartedly recommend this book for its thoughtful, balanced and well-referenced presentation integrating scientific evidence with practical clinical experience."

David Riley, MD

Editor in Chief - EXPLORE - The Journal of Science and Healing

Clinical Associate Professor - Univ. of New Mexico School of Medicine

".... I enthusiastically welcome this book, a collaboration written by experienced clinicians within the fields of conventional, integrative and natural medicine for health professionals who wish to effectively counsel their patients on the safe and beneficial use of dietary supplements. As the title suggests, this book addresses herb-drug interactions, nutrient-drug interactions, and drug-induced nutrient depletions in a clinically oriented, and integrated manner. The authors demonstrate an appropriate balance between recommendation and risk based upon the overall strength of the scientific evidence and their own clinical experience. The text is well referenced, balanced and objective and the use of icons and summary tables allows the clinician to quickly identify areas of potential risk, as well as potential benefit. This book is a major contribution to the field of integrative medicine and an invaluable resource to practitioner and researcher alike."

from the Foreward, by

Tieraona Low Dog, MD

Director of Education, Program in Integrative Medicine

Clinical Assistant Professor, Department of Medicine

University of Arizona College of Medicine

Chair, U.S. Pharmacopeia Dietary Supplements Information Expert Panel

For further information, including book samples and reviews in professional journals, visit MedicineWorks athttp://www.medicineworks.com

AOMA Acquires New Campus

2010-02-04T14:24:00.000-08:00

AOMA in the Statesman

View Larger Map

February 1, 2010

AOMA announces new campus location

Enrollment growth, alternative medicine trends driving expansion

Note: Media are invited to a brief event at the new campus Tuesday, Feb. 2, at 11 a.m. Speakers, who will also be available for interviews, include AOMA President Dr. William Morris, AOMA Board Member Betty Edmond, and Seton Vice President James Davis. Qi gong and acupuncture demonstrations will be given, and drawings and plans for the new campus will be on display.

AUSTIN—Leadership of the Academy of Oriental Medicine at Austin announced today that the college will be expanding to a new, larger main campus in the spring of 2011. AOMA’s new 19,000 square foot headquarters campus, at 4701 WestGate Blvd., will include smart media classrooms, a student intern clinic, a mind/body center, faculty and administrative offices, a library, student and faculty gathering spaces, quiet and group study areas, an herbal medicine center and a bookstore/retail space.

“Acupuncture and Chinese medicine are increasingly recognized as important components in American healthcare,” says Dr. William Morris, president of AOMA. “With our internationally renowned faculty, demonstrated student success, and a new campus designed to provide excellence in every aspect of teaching, learning and student life and support, we are positioned for national leadership.”

A primary benefit of the new campus, Morris says, is that its master plan is designed to meet the specific needs of AOMA’s growing student population. Continued growth is expected because of the college’s new status as the first and only stand-alone, single-degree granting school of acupuncture and Chinese medicine in the nation to be regionally accredited. AOMA became accredited by the Commission on Colleges of the Southern Association of Colleges and Schools (SACS) in December, 2009.

AOMA offers a masters level graduate program in acupuncture and Chinese medicine, preparing its students to be skilled, professional practitioners. SACS accreditation signifies that AOMA has a mission appropriate to graduate education; resources, programs and services sufficient to accomplish and sustain the college’s mission; clearly specified educational objectives in line with the degree offered and proven success in achieving its stated objectives.

Since its founding in 1993 AOMA has grown rapidly in size and reputation, drawing students from around the nation and faculty from around the world. Current student enrollment is 204, and the school has more licensed graduates than any other acupuncture and Chinese medicine school in Texas. AOMA also conducts more than 20,000 patient visits annually in its student intern and professional clinics.

The use of acupuncture is on the rise in the United States. The number of visits rose from 27.2 to 79.2 per 1,000 adults between 1997 and 2007. According to the National Health Interview Survey (NHIS), approximately 3.1 million adults in the United States used acupuncture within the year prior to 2007, a 47 percent increase from the 2002 NHIS estimate. The increases are related to increasing evidence for acupuncture in the treatment of medical ailments including chemotherapy-induced nausea, chronic back pain, hypertension and allergic rhinitis.

James Davis, senior Vice President for Mission Integration, Seton Healthcare Network says, “We have seen increasing demand for alternative and complementary medicine from our patients, and have been pleased to partner with AOMA administration and faculty to provide this care at Seton Medical Center Williamson and Seton GoodHealth Commons. AOMA curriculum includes the study of integrating acupuncture and Chinese medicine with Western medicine, and students are able to see how this works in practice through our partnership,” Davis says.

AOMA Student Association President Cynthia Clark says students are looking forward having a new main campus, and to participating in the detailed design process. “The plans for the new campus are exciting for students,” Clark said. “The new campus has a more cohesive feel. We will have a larger library, improved technology, more space for clinical practice, and better places to gather and to study,” she said.

AOMA’s student intern clinic and bookstore/retail space are already open at the new 4701 Westgate Blvd. site. The existing professional clinic and bookstore/retail space at AOMA’s current location at 2700 West Anderson Lane will remain to serve patients and customers after the new campus is in full operation beginning in April, 2011. AOMA also serves patients at Seton Topfer clinic, Seton GoodHealth Commons, and People’s Community Clinic.

The extensive remodeling of the new campus site has been designed by Austin architectural firm Steinbomer & Associates, known for their design of Austin Studios, the private airport hangar at Austin-Bergstrom Airport and 524 North Lamar, among other projects. Detailed design is currently underway, with construction anticipated to begin in winter 2010. The outline of the new campus design is available at www.aoma.edu.

###

About AOMA

The Academy of Oriental Medicine at Austin offers a masters level graduate program in acupuncture and Chinese medicine, preparing its students for careers as skilled, professional practitioners. AOMA is known for its internationally recognized faculty, award-winning student clinical internship program, and for having more licensed graduates than any other acupuncture and Chinese medicine school in Texas. Since its founding in 1993, AOMA has grown rapidly in size and reputation, drawing students from around the nation and faculty from around the world. AOMA also conducts more than 20,000 patient visits annually in its student and professional clinics. AOMA collaborates with healthcare institutions including the Seton Healthcare Network, and gives back to the community through partnerships with nonprofit organizations and by providing free and reduced price treatments to people who cannot afford them.

The Academy of Chinese medicine at Austin is located at 2700 West Anderson Lane, Austin, Texas, 78757. AOMA also serves patients and retail customers at its south Austin location, 4701 WestGate Blvd. For more information see www.aoma.edu or call 512-492-3051.

A biomedical view of Shang Han Lun

2010-01-17T13:07:00.000-08:00

Date:

Tuesday, January 19, 2010 - 19:00 - 20:00

Presenter:

Will Morris

Watch this Webinar:

Click here to enter webinar: it's Free & No registration required

In the biomedical view of Shan Han Lun, we will explore western physiological concepts related to the practice of Shang Han Lun. We discuss concepts such as the peripheral nervous system, the sympathetic-parasympathetic axis and the affects of the neuro-vascular-humeral loop. Western systems theory is woven into the Shang Han Lun Stages.

Acupuncture Improves Quality of Life Among Breast Cancer Patients

2010-01-16T04:57:00.000-08:00

Eleanor M. Walker, et al at Henry Ford Hospital (Michigan), determine that “Acupuncture appears to be equivalent to drug therapy in these patients. It is a safe, effective and durable treatment for vasomotor symptoms secondary to long-term antiestrogen hormone use in patients with breast cancer.”

They studied 50 breast cancer patients, randomized to receive either acupuncture or drug (venlafaxine) treatment for 12 weeks. Both groups experienced a 50% decline in hot flashes and depressive symptoms. Over time, the acupuncture group experience minimal hot flashes, while the drug therapy group had a significant increase in hot flashes. The acupuncture group did not experience an increase in the frequency of their hot flashes until three months post-treatment. The group further sated that ”the acupuncture group experienced no negative adverse effects. Acupuncture had the additional benefit of increased sex drive in some women, and most reported an improvement in their energy, clarity of thought, and sense of well-being.”

While 50 is an insufficient number to create the power to generalize, this is a very promising study. It is one more piece of knowledge that demonstrates that acupuncture and Chinese medicine have a place in the American medical systems.

Go here for a link to the study

AOMA Accreditation - Integrator Blog Top 10

2010-01-11T08:01:00.000-08:00

Integrative Medicine and Integrated Healthcare Round-up: December 4, 2009-January 5, 2010

Two Integrator Top 10 lists for integrative care from 2009 ... LA Times article on licensed CAM practices and non-discrimination provision in Harkin's Senate health legislation ... George DeVries' transformation of American Specialty Health into a health and wellness firm ... Academy of Oriental Medicine of Austin becomes first AOM school to gain regional accreditation ... Adam Perlman, MD, MPH and Ben Kligler, MD, MPH take over as chair, vice chair for CAHCIM ... AOM accrediting agency still seeks comments on "First Professional Doctorate" standard for the field ... Frank Nicchi, DC, MS honored for strengthening chiropractic-public health ties ... Bravewell, the IOM and the AARP join to found Healthy Nation Partnership; inputs solicited ... American Association for Health Freedom becomes Alliance for Natural Health-USA ... New York Beth Israel creates no-cost, online Prepare for Surgery program ... Seattle-based Alternative Health Access Campaign seeks to meet growing demand among the homeless ... Oregon's largest natural health clinic opened by National College of Natural Medicine ... Chiropractors in campaign to regain recognition as providers by Boy Scouts of America ... Integrative Healthcare Symposium sponsors major conference in New York, February 25-27, 2010 ... North American Research Conference on Complementary and Integrative Medicine set for May 15-18, 2012 in Portland, Oregon ... New American Holistic Medicine Research Institute formed with led venerable Robert Anderson, MD in lead; sets sights on first multicenter project ... Massage accrediting agency seeks public member ... H1N1 lifts dietary supplement sales ... Michael Cohen re-frames his legal services

Pulse diagnosis from a 10,000 foot view: Time Space State

2010-01-04T05:21:00.000-08:00

Dear All:

Thursday, January 14th 07:00 pm - 08:00 pm PST Pulse diagnosis from a 10,000 foot view: Time Space State. I provide the backbone for my dissertation on Chinese Pulse Diagnosis: Epistemology, Practice and Tradition. It's free, it's cool.

Click here to watch the webinar:

http://healthstream.tv/tv/pulse-diagnosis-10000-foot-view-time-form-and-state

Pulse diagnosis from a 10,000 foot view explores pulse from the perspective of how we build clinical knowledge from the pulse. It structures the information according to time, space and state. Useful methods are discussed, such as the use of the three burners for selecting back shu points. Warmly,

Will

Other topics this month on TCMTV - go to this link and click on the calendar option for access http://tcmtv.net/

Tuesday January 19th 7-8pm PST Biomedical View of Shang Han Lun

Tuesday January 26th 7-8pm PST Politics of Evidence

Politics of evidence is a discussion that is vital to the evolution of Chinese medicine in the west. With the advent of Evidence Based Medicine, we are quickly defining what constitutes good knowledge. This presentation speaks about the risks, benefits and alternatives to the emerging Evidence Based Medicine standards.

Happy New Year...

2010-01-01T14:37:00.000-08:00

Dear People of the AOMA community

Happy New Year...

Here is to wishing you great health, wealth, happiness and harmony. It is such a great privilege to serve where transforming lives and communities is the mission.

In reflection, 2009 was an amazing year for AOMA. We achieved membership in the Southern Association of Colleges and Schools http://sacs.org/. This is a unique honor and it makes AOMA a representative of high quality education in the field of acupuncture and Oriental medicine. Anne Province is who I will name as the prime mover on this extraordinary multi-year effort.

The facilities team timed and performed the build out of a new clinic for AOMA that is sparkly. Smart rooms were implemented, so that the LCD projectors are drop downs from the ceiling. The foot print of the campus was reconstructed around a “back quad” with the Coi pond and turtles in the center. All of the potential chaos was contained and the move happened in a way that people were comfortable, and change management can be a demanding set of efforts. Kudos to the facilities team – Stuart Bailey and Aaron Shafer. Linda Fontaine – the genius negotiator made it possible and Anne Provicnce the genious planner made the timelines spot on!

The Student Association leadership under Cynthia Clark has flourished with learning activities and participation in national professional association activities. AOMA is truly fortunate to have such a committed and active group of students. It is often times difficult to raise one’s head above the demands of building the knowledge, skills and abilities of a new profession. This group of people has a vision and I believe will make a difference in the field.

It is AOMA’s faculty who are the resource that these efforts are built to ensure

There are new developments in clinics, the Southwest Symposium and other updates regularly refreshed by the awesome Sarah Bentley - http://www.aoma.edu/.

Brenda Thompson is doing a spectacular job assisting us in getting our message out http://www.brendathompson.com/.

Thank you all - much love and happiness in the New Year!

Warmly - Will

AOMA accredited by SACS

2009-12-15T11:13:00.000-08:00

On Monday, December 7^th at 5:00pm, AOMA (Academy of Oriental Medicine at Austin) achieved membership in SACS (Southern Association of Colleges and Schools).

Dear AOMA Community,

Anne Province and I are here at the SACS Conference in Atlanta

Georgia

. We have great news. The Academy of Oriental Medicine at Austin was granted full membership in the Southern Association of Colleges and Schools (SACS).

Thanks to each and every one of you for the efforts you have placed in this endeavor. It is a sign of the excellence this community brings to the table, not just in our field but in the field of higher education. We are transforming lives and communities.

Thank you!

Will and Anne

Accreditation is a voluntary process whereby academic institutions seek recognition for meeting academic standards. AOMA maintains both programmatic and regional accreditation. Accreditation is typically conducted by private not-for-profit agencies, which receive recognition from the USDE (United States Department of Education).

For learners in the AOMA community, accreditation gives a particular sheen of quality to the degree. On a practical level, a regional accredited degree allows for transfer of credits into other university programs when appropriate. Similarly, graduates of AOMA’s master degree program may qualify to enter PhD and other doctoral programs with master degree requirements for admissions. A regionally accredited master degree also makes it possible for AOMA graduates to teach in college settings.

Regional accreditation is AOMA’s most recent land mark accomplishment. It is a high level of quality recognition for the AOMA community including students, faculty, staff, patients, partners, alumni and board of governors. Most well-known colleges or universities participate in regional accreditation. As AOMA’s president, I sit next to presidents of schools ranging from Texas A&M to Pearl River Community College in Poplarville, Mississippi to Georgia Tech. It is inspiring and it is a new day for the AOMA community.

AOMA has experience in programmatic accreditation via ACAOM (Accreditation Commission for Acupuncture and Oriental Medicine) since 1996. Programmatic is a specialized accreditation for educational programs that prepare people for specific professions. Schools of medicine, psychotherapy, chiropractic and physical therapy all have programmatic accreditors. ACAOM does this for acupuncture and Oriental medical education.

AOMA is the first single purpose school of AOM (acupuncture and Oriental medicine) to achieve regional accreditation. Other schools have accomplished regional accreditation with multiple programs. AOMA is also the first school of AOM in the SACS (Southern Association of Colleges and Schools). Further, SACS is the last regional accreditor to recognize a school with an AOM program. We save the best for last!

Here is my official communication to the AOMA community when we discovered that we were invited to the official reception for new SACS member schools:

Interlude from Guangzhou - Book Deal in Beijing

2009-11-25T03:08:00.000-08:00

During my recent visit to Guangzhou, I took a couple of days to meet with the team at People’s Medical Publishing House. The flight was only a few hours, and I took a cab to the multi-story facility in downtown Beijing.

My project, a book on pulse diagnosis, focuses upon the works of one of

China

’s great compilers, a man named Li Zhishen. Author of one of the great herbal compendiums, Li has also published two works on pulse diagnosis, one is the Lakeside Master and the other is the Mysteries of the Extraordinary Vessels.

In order to realize a quality work, the team involves two authors, two editor/project managers and two translators. The individuals involved are: Walter Liu (Líu Shuĭ, 刘水), Vice-Director of International Publications Department and head of Department of Clinical Chinese Medicine and Integrative Medicine; Harry F. Lardner, Department of Clinical Chinese Medicine and Integrative Medicine; Amber Huang (Huáng Lĕi黄蕾), Department of Acupuncture and Tui Na; Mark Mondot, Department of Patient Education.

This "golden bridge" of international collaboration in the development of Chinese medical knowledge is significant news for the profession. Each section of the team involves an American and a Chinese person. This type of collaboration allows for a rich representation and accurately portrays the source material while maintaining sensitivity to the needs of the user.

Pulse diagnosis is my area of academic specialty. I have spent 28 years on the topic. My latest efforts are in an area that I call medical epistemology – that is – how we build knowledge in medicine. Pulse diagnosis is an area of practice that is often dismissed as subjective. It is. And that is the advantage. We, in this world of high tech and looming global chaos need a personal touch. Pulse diagnosis provides a direct and immediate non-verbal contact between the physician and the patient.

People’s Medical Publishing House is the largest and most influential book maker in

China

. I felt privileged to participate with the group on a project that fit exactly with my values with respect to translation and the building of knowledge across the cultural and language bounds. I had an opportunity to see the galleys for Understanding the Jin Gui Yao Lue - A Practical Textbook. This is one of the most important historical texts in Chinese medicine, one that is still used in core curriculum for Chinese medicine programs at the major universities in

China

. The core text of the Essential Prescriptions of the Golden Cabinet (Jīn Guì Yào Lüè) has been praised by Chinese physicians as "the book that saves lives" and "the ancestor of all formula books".

I believe that PMPH is doing very important work and it is a privilege to participate with them on the development of Chinese medicine in the West.

International Conference on Traditional Medicine November 9-1, 2009 in Guangzhou,China

2009-11-13T08:33:00.000-08:00

I went to Guangzhou, a southern coastal city which is the 3^rd largest in

China, population, 10 million as of the 2007 census. The purpose – to present a paper called Strategies for Globalizing Chinese Medical Research: Standards, Cost of Care Studies and Ethics.

90 countries were promoting the inheritance, development and internationalization of Traditional Chinese Medicine. There was a call for Evidence Based Medicine (EBM) as the sign post of what would make Chinese medicine acceptable in the world.

Those of you who know me, know that I take some exceptions to rote EBM as a path for creating acceptance of acupuncture and Chinese medicine on global platform. I am also happy to use EBM to make a point. More on this later.

The conference was sponsored by all levels of Chinese government:

Ministry of Science and Technology, P.R.China

Ministry of Health, P.R.China

State Administration of Traditional Chinese Medicine, P.R.China

State Food and Drug Administration

Ministry of Education, P.R.China

State Ethnic Affairs Commission, P.R.China

Ministry of Agriculture, P.R.China

Ministry of Culture, P.R.China

General Administration of Quality Supervision, Inspection and Quarantine, P.R.China

State Forestry Administration, P.R.China

State Intellectual Property Office, P.R.China

Chinese Academy of Sciences

Chinese Academy of Engineering

National Natural Science Foundation of

China

People’s Government of Guangdong Province

The WHO co-sponsored the event.

It was the People’s Government of Guangdong Province (Guangdong Science and Technology Department) who did the heavy lifting for the conference organization.

Mr. Wan Gang, Minister of the Ministry of Science and Technology gave a presentation called: Promoting the Modernization and Internationalization of TCM for the Benefit of Society.

Development of TM is practical and significant. The financial tsunami the integration of different civilizations and issues around the economic gap place the global ecological concerns. Medical care H1-N1 AIDS and SARS are part of the return to traditional medicine which connected with the people’s need to get back to nature. The goal is a harmonious and globalized point of view.
Specific features of traditional medicine. Early practices use of senses to evaluate the disease process. For example pulse diagnosis, observation, inquiry. This approach point of view is holistic dynamic and personalized. Because it is a treatment in light of the person the time and place. This brings advantages beyond the substantial contributions of genetics and epigenetics. As time goes on, these practices can be difficult to accept by people trained in the contemporary societies and scientific world view. This makes traditional practices difficult to evaluate using the contemporary scientific method. We need to seek a development path for TCM
Strategic consideration for TM. It is a valuable asset that has taken centuries to develop. We need to promote the medicine along with science and technology in order to further internationalization. Medicine does not only aim at curing disease, we must also be involved in the following

Improve prevention and treatment
The healthcare and diagnostic systems
Technology
Enrich the theoretical system
Set up international standards and norms
Develop unique technology
Network for international science and technology

The Deputy Minster of Health Wang Guangzhou said that we must Seize the Opportunity for Government Collaboration and Development. He said that TM is an important inheritance for human civilization. TM has enriched and made great contributions to the health and prosperity of humanity for millennia.

More to come on the conference and the research presentations in my track which was on acupuncture research. Hint - there was some very cool studies using 24 hour blood pressure monitors.

Warmly,

Will

Developments in the Field of Acupuncture

2009-11-01T08:27:00.000-08:00

Trends

In 2007, adults in the United States spent $33.9 billion out-of-pocket on visits to complementary and alternative medicine (CAM) practitioners and purchases of CAM products, classes, and materials for self-care. Nearly one-third of this out-of-pocket spending was to pay for CAM practitioner costs (see figure below.) Further, according to this government survey, the number of visits to acupuncturists rose 32% between 2002 and 2007. Also, nearly 12% of the out-of-pocket money was specifically spent on yoga, Tai chi and Qi gong for self-care (see figure below). Link to the press release: http://nccam.nih.gov/news/2009/073009.htm National Health Statistics Reports (NHSR), (Number 18, July 30, 2009) as well as the earlier, NHSR (Number 12, December 10, 2008).

Legislative Efforts

The AAAOM is strengthening its new alliance with the National Foundation of Women Legislators (NFWL), which represents America’s 2146 elected women legislators. These women either chair or constitute a majority on the health committees of all 50 state legislatures. There are now 17 women U.S. Senators and 73 Congresswomen in the

U.S.

House of Representatives. The group made this resolution at their annual meeting in New Mexico over Labor Day weekend:

NOW THEREFORE BE IT RESOLVED by the National Foundation for Women Legislators Healthcare & Empowerment Policy Committee, that Congress should ensure that licensed acupuncture practitioners are included as providers in all government insurance programs and health delivery programs;

BE IT FURTHER RESOLVED by the National Foundation for Women Legislators Healthcare & Empowerment Policy Committee, that all 50 states governments, territories, and tribal communities are urged to license the practice of acupuncture and Oriental herbal medicine or improve their licensure guidelines to encourage a broader scope of practice.

The connection between the AAAOM and the NFWL, was facilitated by Washington, D.C. lobbyists Sam Brunelli and Beth Clay. With their help the AAAOM has increased Congressional sponsorship of the Federal Acupuncture Coverage Act (HR 646) from 15 to 29 Representatives. Sam and Beth have received over 30,000 letters from patients in support of HR 646 to deliver to members of Congress and the Senate.

China Acupuncture Conference Research Presentations

2009-10-27T04:26:00.000-07:00

On the 4th of November, 2009, I depart for a conference in Guangzhou, China. These are the two presentations that I will make. Strategies will be a keynote address.

Strategies for Globalizing Chinese Medical Research: Standards, Cost and Ethics

This strategic discussion is designed with the hope of increasing the acceptance of Chinese medicine on a global platform. In support of this vision, I will present three topics. First includes standards for reporting research. Second, involves demonstrating cost effectiveness of Chinese medicine. Third, is the Institutional Review Board, its history and importance to the acceptance of research. These three features of standards, cost and ethics may affect the rate at which Chinese medicine is accepted by policy makers. I form this opinion, as a practitioner with 23 years of experience in the US, as a past president of the American Association of Acupuncture and Oriental Medicine and leader at two schools of Chinese medicine in the

. I therefore request for more cost effectiveness studies with Chinese medicine, adherence with reporting standards and the development of institutional review board practices.

Qualitative Inquiry: Paradigms, Methods and Inquiry

The field of acupuncture and Chinese medicine may be moving beyond the issues of controlled trials and entertaining the idea of qualitative research. There is however, little discussion about the paradigmatic assumptions behind any particular method of inquiry. Here, I discuss paradigms, methods and perceptions of validity that drive approaches to research. I also present a method and some glossary related to validity in qualitative research. The purpose is to expand the discussion about what constitutes evidence in the practice of Chinese medicine.

The discussion develops concepts of paradigms or world views. Assumptions that drive choice in research about subject matter, reasonable evidence and how that evidence is presented, comes from such world views. From paradigms, we move into the placement and methods of qualitative research. This section is not intended to be exhaustive, but rather, to provide a sense of the common practices employed in qualitative research methods. Validity is taken next, since the discussion of validity in qualitative research uses different language than the practices of quantitative methodology. The practice of triangulation in qualitative research is also discussed.

The School's Role

2009-10-02T06:35:00.001-07:00

I believe that a school of acupuncture and Asian medicine best serves the communities of interest if through its mission; it also has a concern for the wider community and ecology in which it operates. Specifically and strategically, it should be inclusive and conscious of its effect on the planet, country, state, city, organizations and individuals.

For a school of acupuncture and Oriental medicine to succeed, it places the interest of the profession and its graduate’s success first.

Is Asian more Pejorative than Oriental?

2009-09-20T06:21:00.000-07:00

I wrote this piece in response to the changes that happen with respect to language and terms that we use to describe who we are and what we do. In the Roman Empire, the term Asian was bloodied by the spread of empire. Today, the term Oriental is in decline, and the states of California, Washington and New York have purged the term Oriental from their legal documents. What was once a term designed to avoid national centrism and equitable representation of medical practices from the East has now been framed in the West as a term associated with hegemony.

First published as an Op Ed in Acupuncture Today May, 2007, Vol. 08, Issue 05

There is currently much debate within the medical field about the proper naming of medical practices which have their roots in China. It has gone to such extremes that the California legislators officially changed the word Oriental to Asian However, in an effort to be politically correct, they may have missed the mark.

Asian
The words ‘Asian’ and ‘Oriental’ have similar roots. In ancient times, they referred to the direction of the rising sun. The term ‘Asian’ occurred in Greece as a descriptive for what is now Turkey some fourteen centuries before the Common Era. Further, ‘Asia’ may come from the Akkadian word (w)aṣû(m), which means "to go out" or "to ascend," referring to the direction of the sun at sunrise in the Middle East; it is also likely connected with the Phoenician word asa meaning east. For the Greeks and Romans, the term ‘Asian’ described those peoples whose power and territory were usurped in an imperialistic and hegemonic attempt to rule the world.
Oriental

The term ‘Oriental’ emerged during the post enlightenment era in connection with the European fascination with Eastern culture. The origins of the term ‘Orient’ c. 1300 originally referred to the East. By the time of the 19^th century ‘Oriental’ was connected to the colonization of the Near-East and the East by France and England and later the United States. It was during this time frame that ‘Oriental’ was used to express European imperialism at the material, aesthetic and sociological levels. According to Edward Said, “Orientalism, a way of coming to terms with the Orient that is based upon the Orient’s special place in European Western experience” (1978). Thus the post enlightenment and imperialistic world of England, France, and later the

United States

, used the term ‘Orientalism’ as a reference to character, style, trait, or idiom felt to be from the Orient.
1970’s Development

The histories of these two words pose an interesting quandary for the present day field of acupuncture and Oriental medicine (AOM). We now ‘fast forward’ to North America in the late 1970s. The Chinese, Korean and Japanese communities are developing a legal structure for their culturally distinct medical practices. The Japanese and Koreans adopted the term ‘Oriental Medicine’ in order to reflect their medical practices as distinct from the Chinese yet sharing a common foundation.

Under these circumstances, the term ‘Oriental Medicine’ developed into a brand identity. Regulatory agencies throughout the United States began using the term ‘Oriental’ as part of the language of legislature and incorporation. Several agencies adopted the term. These included the Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM), the Federation of Acupuncture and Oriental Medicine Regulatory Agencies (FAOMRA), the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM), and the American Association of Acupuncture and Oriental Medicine (AAAOM).

Currently, the term ‘Oriental Medicine’ is identified with the aggregate practices of acupuncture, herbal medicine, manual therapies, cupping, moxibustion bleeding, exercise therapies and dietary therapies. The field has matured in terms of its identity

We find some commonality for use of the terms ‘Oriental’ and ‘Asian,’ in post modern medical practices of North America. Both terms are rooted in an desire to fairly represent cultural practices from the Far East . The dominant cultures and countries that brought the practices of acupuncture and Oriental medicine to the West, notably, China, Japan and Korea seek to be identified fairly.

However, the identity of Asian medical practices tends to lack specificity due to the wide-ranging geographical, cultural and medical influences. Consider the following facts. The Thai, Vietnamese, as well as the sub-continental practices of the Unani Tibb, Ayurvedic and Buddhist medical disciplines have unique features of practice. But they have no licensing status or official regulatory recognition at this time. Further, the full plurality of medical beliefs and disciplines practiced throughout Asia involve more than 60% of the global population. It is also the earth’s largest continent with 29.4% of the land mass. It is necessary to create clear practice and geographically based description of the profession.

Chinese Traditional Medicine
Some linguistic authorities such as Heiner Fruehauf and Paul Unschuld recommend using the term ‘Chinese Traditional Medicine.’ Ideally this captures the heterogeneous body of practices that compose the history of practice. However, the use of this description poses nationalistic concerns for the Vietnamese, Korean and Japanese communities, not to mention the French, English, Dutch and Americans.
While these ethnographic and cultural concerns are debated, the American public has a small but growing awareness of what ‘Oriental Medicine’ entails. The western community is increasingly aware of acupuncture and that disciplined training is necessary for its successful practice. The phrase acupuncture and Oriental medicine captures this very well.

Oriental Medicine
The contemporary American use of the term ‘Oriental Medicine’ has a positive, specific and historical usage that emerged when the discipline was constructed into a professionally recognized in the

during the late 1970s. Generally speaking, the term is inclusive of the entire body of medical practices in which certified and licensed acupuncturists in the

USA

engage. It includes a plurality of national origins as well as methodologies. Therefore, my recommendation is to remain with the name ‘Oriental Medicine.’

[I no longer make this recommendation due to the changing legal and cultural climate involving the term Oriental.]

Said, E. (1978). Orientalism. New York: Random House.

Lorena Monda, DOM

2009-09-13T04:00:00.000-07:00

Keynote Address AOMA Graduation September 12, 2009

I am delighted and honored to be here to celebrate your graduation with you. Last Sunday I was sitting in a meditation hall at Deer Park Monastery in Escondido, California listening to Zen Master Thich Nhat Hanh speak. His talk was about happiness. He talked about the capacity to stop and mindfully recognize a moment of happiness. To know a moment of happiness when it is present. To feel the energy of happiness in yourself. So let’s do that now—stop for a moment, and recognize this happy moment. Take a moment to acknowledge and feel your accomplishment, which has come to fruition after years of hard work.

Ceremony belongs to the realm of the fire phase, the realm of the shen and the heart. The heart allows us to joyfully connect with others, to feel and offer gratitude to all the people and things that have inspired us and gotten us to this potentially happy moment: our teachers, for example, our loved ones. Shen locates us in the here and now, and allows to act from our deepest intentions and aspirations in the here and now. It seems important to remember your aspirations—what drew you to this medicine those years ago—as you stand on the threshold of making this medicine your own.

Making Oriental Medicine your own—that is the key to your success as a practitioner. You have learned from many teachers, the stream practitioners before you who have kept this medicine alive for thousands of years. And now it is your turn to step into the stream.

How do you make Oriental Medicine your own? You make time and space to listen for what inspires you. You allow yourself to be nourished. You find what makes you happy. You trust yourself. You cultivate your talents and gifts, the things that make you unique as a practitioner. You know and respect your limits. You cultivate internal and external resources to help you. You find what offers you encouragement when things get tough. You stay curious. You keep learning. You develop a relationship to the unknown. You let your patients and your challenges teach you, and let your experiences make you wise. If you do these things, people will be happy come to you for treatment.

25 years ago, I was in your seat, happily graduating in a graduating class of 8 people, in a country where it was legal to practice our medicine in only a handful of states (Texas was not one of them). 25 years ago when I told people that I practiced acupuncture, many of them said “what’s that?”

I was drawn to our medicine because of its beauty and power. Because it treated people as whole beings. Because it worked. I was drawn to this ancient medicine, because it was something “new.” I was excited because I knew that I could have a hand in shaping how Oriental Medicine was practiced here in my country, in my time.

25 years later, this is truer than ever. We are still pioneers. What many of us have known for so long is now at the forefront of the national debate: Our healthcare system is broken. We are fortunate that we practice a medicine that has the power to transform, not only individual lives, but communities, society, the planet. There has never been a time in the history of Oriental Medicine in America when we did not have to pay attention to our place in the larger society. Whether we are conscious of it our not, or whether we want it or not, this is part of our medicine.

Right now we have the opportunity, not only to influence the practice of Oriental Medicine, but to participate in the transformation of our whole healthcare system. If there was ever a time to get involved at this level it is now. There are great people in our profession doing great work in this regard. Some of those people did the hard work of making it so you can practice legally in all but a handful of states in the US today. We have helped millions of people. We have made inroads into hospitals, community clinics, medical schools, nationally funded research projects, regional accreditation boards, etc. My father-in-law used to send us clippings from the newspaper or magazines whenever acupuncture was mentioned (I think it was his way of saying, “so this is really legitimate.”) He has stopped doing that lately. I think he gets it now.

Last weekend, in New Mexico—a state where oriental medicine practitioners worked for and achieved primary care physician status—New Mexico acupuncturists in conjunction with the AAAOM, our national professional organization gave about 100 treatments to legislators from all over the country at the National Foundation for Women Legislators conference. (They loved it by the way. The first brave few, told their friends, and then there was a deluge…) We did this because we wanted the work we do, the medicine we practice, to be in the awareness and felt experience of lawmakers at a time when the healthcare system is on everyone’s mind.

I encourage you to include as part of your professional life, the active participation in your state and national acupuncture associations. I encourage you to include the healing of communities, society, and the planet in your vision of how you practice Oriental Medicine.

Now, just a couple fun facts to launch your careers:

In 2006—the first of the 76 million baby boomers, the generation born between 1946 and 1964, turned 60. As a member of this generation, the generation that brought alternative medicine to the edge of the mainstream, I can say that we have never been content with the status quo, even as we are creating it. 76 million baby boomers getting old…I am sure we don’t want to do getting old the way it has been done before… I recommend knowing something about geriatrics…

In 2007—more babies born in the US than in 1957 the height of the baby boom, so some pediatrics wouldn’t hurt either….

Lastly, I want to remind you that you if you plan to make this profession your livelihood, you have made a lifelong commitment to cultivating a relationship with qi, healing, and transformation, and that includes your own. I wish you many moments of happiness in the practice of this beautiful medicine. I am happy to have you as my colleagues.

Congratulations!

Acupuncture and Oriental Medicine Education, Critical Thought and Complexity

2009-09-11T11:03:00.000-07:00

First published in Acupuncture Today November, 2008, Vol. 09, Issue 11
Knowledge is not an object or a tool that can be used without studying its nature. It is a question of preparing minds to reach for clarity. Part of this comes with the awareness that what we know is subject to error. There are several bases for these errors of knowledge, which might include rational thought, emotions, blinding by paradigms, face saving, resistance to change, conformity, stereotyping and self-deception, the unexpected and uncertainty (Morin, 2001; Ruggiero, 2006). Understanding how knowledge is built should figure as a primary requirement to prepare the mind to confront the constant threat of error and lack of critical thought that can and has affected the progress of the profession of acupuncture and Oriental medicine.

The purpose of education is to transmit knowledge. However, education is “blind to the realities of human knowledge, its systems, infirmities, difficulties, and its propensity to error” (Morin, 2001, pp 11-12). Historically, certainty has posed a level of vulnerability that has been repeatedly proven over time by the likes of Galileo, Keppler and Prigogine. Yet, education in general still does not bother to teach what knowledge is.

Our way of knowing and acting in our world, continually reinforced by our cultural conditioning, has established a complex interlocking system. Everything, including language, educational systems, economies, commerce, politics, and social institutions: is dependent upon everything else. Underlying this great superstructure are our concepts, beliefs, assumptions, values, and attitudes, which are linked together like an underground network of pipelines connecting across a vast continent (Tulku, 1984). Universities teach emergent science and technology, however the premises of thought upon which all our teaching is based are ancient and…obsolete (Bateson, 2002).

It is time for an educational process that is based on inquiry into uncertainty, the global crisis and complexity. Education has an ‘anthropo-ethical’ mandate vis-à-vis individual-society-species (Montuori, 2005). It takes place through a human awareness of individuality concurrent with a conscious participation and awareness as a member of the species and a member of society. Taken as a mode of transformation and preparing members of society, we might consider four primary areas of scholarly inquiry for the professional, they include: personal transformation, improvement of professional practice, generation of knowledge, and the appreciation of the complexity, intricacy, structure and beauty of reality (Bentz & Shapiro, 1998).

It seems important to discuss the difference between “informative’ and “transformative” learning at this point. Informative learning is the acquisition of knowledge, skills and attitudes. Transformative learning brings about a transformation in self-identification, the role the individual maintains within the culture and in the ways of thinking, communication and defining knowledge. Therefore – all learning is transformational in some dimension. What becomes important is where the transformation takes place, for what purpose and whether it is designed as part of the educational outcomes.

If inquiry, learning and knowledge are to be pertinent, education must elucidate these factors: I must penetrate my reactions to and affinities towards the matters of question. I must unhinge myself from the biases of patterned belief to consider the great potential of error in thought, perception, recall and conclusions. This may create a space for learning, knowledge and inquiry to occur authentically and with a modicum of validity. To this end I will discuss six thought habits that can distort critical thinking including these concepts: mine-is-better, face saving, resistance to change, conformity, stereotyping and self-deception (Ruggiero, 2006).

Mine-is-Better

The idea that ‘mine-is-better’ is a basic human trait that can be observed in child-hood as well as various stages of civilization and culture. It is present in academia on the basis of conferred degrees and often supersedes the values of ‘meritocracy.’ The real contributions of an individual are as important as the past accomplishments or degrees achieved.

‘Mine-is-better’ thinking leads to thoughts that consider others are lesser or even subhuman. Historical examples of atrocities stemming from this form of thought abound in the prisons, insane asylums and leper colonies. A weak sense of self often drives this need to bolster the ego by somehow thinking of others as the lesser. We can move away from self-flattering errors and gain more objectivity about what may be a more unpleasant reality. And, if we can recognize the piece in ourselves it is possible to make contributions to unbinding the white male Euro-American dominator system that impairs partnership values in organizational development.

One example of this is the type of thinking that goes on between schools of thought in Asian medicine. We see the mine-is-better thinking in the way that TCM and Worsley practitioners have positioned themselves with each other in the market place. However they seem to both serve their patient populations well.

Face Saving

One of the strongest influences for upset and anger in interpersonal relations is ‘face saving.’ It triggers deep emotional conflicts from past traumas. Looking good is what it is about. People will attempt to take credit for work performed by subordinates and peers in order to look good. This poses an ethical quandary that impairs leadership because people do find out. In addition, they will blame peers, people in the position before and subordinates in order to save face. This disempowers leadership whereas owning the responsibility gains respect and honor. It is bizarre. The very attempt to save face actually causes a loss of face.

Here is an example in the story of the three letters. A president takes office and he finds three envelopes in her desk left by her predecessor. The instructions state: when you get into trouble, open the first envelope. If trouble comes again, open the second envelope. And if it comes again, open the third envelope. So, the new president hits a problem with an external regulatory agency and opens the first envelope and it says, “blame the previous president.” So she does. This gets her through the problem. However, the agency returns and there is another problem and she opens the second envelope. It says “blame your workers.” She gets through this one and a new problem arises so she opens the third envelope. The letter says “get three envelopes.”

Resistance to Change

This is the tendency to resist change and new ways of thinking without a fair analysis. Sometimes this tendency can be very unconscious. A child asked her mother, “why do you cut the end off of the ham when you cook it?” The mother replied, “I don’t know, my mother always did and that is how I do it.” So, the child approaches her grandmother to find out only to hear the same statement, “I don’t know, my mother always did and that is how I do it.” So, the child goes to her great grandmother as asks her “why do you cut the end off of the ham when you cook it?” The great grandmother replies, “we had a very small oven and I had to cut the ends of the ham off in order to get it into the oven.”

Culture is, the way we do things around here. Often this is tied not only to social convention or unquestioned behaviors but also to survival. The psychological drivers against the forces of change can be powerful, evoking survival responses and deep reactions that confound the ability to see what is real. Openness to change is not an abandonment of critical thinking. It is the suspension of judgment long enough to give new ideas a chance.

We saw this when the field went to the master degree in the late 1980s. There was tremendous fear that schools would be put out of business and that there would be unfair competition between practitioners in the market. These fears were never realized. Similar fears drive the current resistance to the development of specialties and first professional doctorates.

Conformity

Conformity can result in peer pressure and group values affecting decisions in place of critical thinking. Rooted in face saving, the desire to not stand out or be different from the group can be powerful. This has political and cultural value when large populations seek to maintain order and is seen as a virtue in Confucian ideologies where a peg must not stand above others on the board. To stand out like this has posed threat to life during various periods of Chinese history such as the Cultural Revolution and the Gang of Four, or the Khmer Rouge, a communist party in

Cambodia

These environments cause one to conform as a means of survival. The cultural developments then extend into work environments in the

and other ‘free’ countries. This problem extends to the personal and behavioral level. An individual can develop a response to a set of circumstances that are overwhelming such as a violent parent. Later in life, the person continues the behavior as a habit, even if it kills them. This is a learned pattern of behavior (habit) that once ensured survival but now impairs life. The conformity is to the learned patterns of behavior.

We find conformity in the national processes of Chinese medicine. For instance, sometimes California acupuncture politics are dismissed because it is “California.” This allows stakeholders in the profession from other areas of the country to write off the opinions of an influential state that has in the past led on legal and educational requirements in the field. In this instance, California politics in AOM are dismissed because they do not conform.

As a point of clarification, there are very good reasons for conformity. However, the need to conform is so powerful that to recognize it and suspend it while giving due consideration to new ideas and concepts will enhance the ability to think creatively and critically.

Stereotyping

Does functional stereotyping have a place? While stereotypes are a convenient way of organizing reality and may provide insight, they must be exposed: they distort our view of reality. “Blinded by stereotype” is a risk if it becomes an irrational and unbending generalization. The most common stereotypes are sexist, racist, religious and nationalistic. This type of thinking dazes and muddles the mind and impairs the ability to sort, analyze and contemplate the nuances of reality. Ruggiero quotes Walter Lippman, “Stereotypes are loaded with preference, suffused with affection or dislike, attached to fears, lusts, strong wishes, pride, hope. Whatever invokes the stereotype is judged with appropriate sentiment…Neither justice, nor mercy, nor truth enters into such a judgment, for the judgment has preceded the evidence” (2006, pp 56).

This is a difficult area. We are a field that is engaged in the transmission of knowledges across language and cultural chasms. Further, one can never underestimate the powers of assumption in multicultural environments to confuse and add fuel to the fire which supports stereotyping as a means of coping. One example is the statement that Asians must learn the rules and regulations of the American environment. While this is true, it becomes a way of dismissing a need for a critical examination of what we are doing in AOM education and the building of legal systems for practice.

Self-Deception

Katherine Anne Porter observes that, “One of the most disturbing habits of the human mind is its willful and destructive forgetting of whatever in its past does not flatter or confirm its present point of view” (Ruggiero, 2006, pp 55). Take blame and resentment for instance, when these are held from the past, they are hardly seen as ones own set of behaviors such as “I was angry.” But the finger of blame is readily pointed. As a teacher in AOM said to me once “it is good to have someone to blame.” This was said in jest, however, when I quoted him, he corrected me stating, “No, that is not what I said; this is what I said, ‘tis human to err, ‘tis more human to blame.” This was a rather humorous interaction and benign, and I recall it endearingly. However, recreating history according to the needs of self worth is powerfully motivating. Looking good and maintaining ‘face’ compel people to recreate history. However, in a group process, when there are discrepancies between the stories and the recollections, this process of self-deception can erode trust.

In Summary

Complex thought is contextual and connecting. An example is the perspective that comes from considering the recursive loop between the individual and society or a social system and global concerns. That idea that individuals make society, and society makes the individual becomes a powerful component of the socialization of the physician. To entertain ‘complex thought’, it may be useful to consider that while the whole is greater than the sum of the parts, the whole is also less than the sum of the parts, and the whole is greater than the whole (Morin, 2001).

References

Bateson, G. (2002). Mind and nature, a necessary unity (6 ed.). Cresskill, NJ: Hampton Press.

Bentz, V., & Shapiro, J. (1998). Mindful inquiry in social research. Thousand Oaks: Sage.

Montuori, A. (2005). Gregory bateson and the promise of transdisciplinarity. Cybernetics and Human Knowing, 12(1-2), 147-158.

Morin, E. (2001). Seven lessons in complex education for the future. Paris: UNESCO.

Nicolescu, B. (2002). Manifesto of transdisciplinarity. Albany: SUNY Press.

Ruggiero, V. R. (2006). The art of thinking. A guide to critical and creative thought. New York: Pearson Longman.

Tulku, T. (1984). Love of knowledge. Berkeley: Dharma Press.

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