Medical acupunc Title Restrictions doctor, physician, or Dr. if a doctoral degree is awarded from a An interesting development in state restrictions on physicians e cognized college or university. 8J practicing acupuncture is how the medical acupuncturists may As more universities and colleges of acupuncture and ori- identify themselves and their practice(as described in category ental medicine develop and subsequently offer doctoral level C"above). Montana is a prime example of this position where programs, a growing body of acupuncture"doctors"may title'acupuncturist'or any similar title unless the person is li- physician of allopathic or osteopathic medicine and the acu- censed under the provisions of this acupuncture statute chap- puncture doctor. It is even debatable whether the standards ter. In Rhode Island, where the title"Doctor of Acupunctur states set for licensure of acupuncturists and the practicing has been awarded to the licensed acupuncturist since 1978, the titles thus granted will change as the ACAOM begins cians to practice"Medical Acupuncture as defined by regula. replace the masters level training in acupuncture, but it may tions, "but they shall not be considered equivalent to licensed be"currently premature for states licensing boards to con- acupuncturists. Rhode Island requires that patients receive ider basing licensure on graduation from a doctoral pro- complete disclosure as to the medical acupuncturist,'s training, gram, "according to the ACAOM. 4, I5J Thus, as the prime route to formal education, as accredited by the ACAOM which must consist of at least 300 hours from a recognized through the U.S. Department of Education, 15,k clinically school and a supervised clinical practicum in order to legally practice.Finally, in New Mexico, acupuncture is considered to practicing graduates of such doctoral programs will be in fact be within the scope of physician practice, but, unless fully li- doctors or " DOMs"performing, in many(perhaps most) censed under the state requirements, physicians are prohibited states,acupuncture and Oriental Medicine for the diagnosis, from using the title"acupuncturist"or any related terms, and treatment, and prevention of disease. even from describing their services as such. New Mexico statute Medical Malpractice: Is this an Issue? declares, "lother physicians] shall not hold themselves out to the public or any private group or business by any title or descrip- Although there have yet to be court cases dealing with mal- tion of services which includes the term acupuncture or acu- practice in medical acupuncture, there are various issues that puncturist unless they are licensed under the Acupuncture Prac- tice Act. B,h Conversely, many states, such as California and ments particular to the conventional phy Washington, are in a mediating position, where the titles"Dr. acupuncture. It will be interesting to see how courts will "OMD, "or "Physician"may be used only when further identifi- handle the issues of standard of care, expert/professional testi cation is explicitly given as to the nature of practice.8 causative injury, and other elements related to malpr Thus, despite the long-standing rule of the American Med- tice specific to acupuncture Shall acupuncture be considered as part of the standard of care as medical communities em- al Association, legal restrictions against"holding oneself out as a medical doctor" through the use of titles may be weak brace it as a legitimate practice, or will there be a separate ening, as some states begin allowing the usage of titles that standard of care dealing with acupuncture? Who would be directly confer to the acupuncturist the role of a healer in the he expert witness or authority for medical acupuncturists? realm of medicine, and more importantly relay to the lay application of medical malpractice specifically to comple patient that the acupuncture"physician"is a valid and per- mentary and integrative medicine in general. 16 Legal writer Michael Cohen, director of Harvard Medical School's Legal As acupuncture continues to be integrated and accepted as a medically valid treatment, it is likely that states will have to respond to the evolving educational mandates set forth by the sTates include Arkansas (DOM if licensed), Hawai (DAC, Doctor, or Dr. formal regulating bodies of acupuncture training and certific Massachusetts(PhD/OMD), New Jersey(OMD or PhD), New York(Do tion On the forefront of developments in acupuncture curricu- tor), Nevada, Utah(Doctor of Acupuncture or Oriental Medicine Doc- lum is the introduction of educational standards for a doctoral tor), and West Virginia, with subtle variability in exact titles permitted. It level degree program in Acupuncture and Oriental Medicine, is worthy to note, though, that some states have other statutes that hibit the use of titles according to certain applications, like education. through which the graduate is awarded a title of "Doctor of What more, the ACAOM has proposed to eventually require all ACAOM Oriental Medicine. "4 This may pose interesting questions on accredited acupuncture training grams to transition to the doctoral how states should regulate the usage of the title"Dr. "in practice. creditation of Masters degree programs in acupuncture after a 10-year transition period, in effect eliminating the ac Although there are currently no schools offering such a degree How this will the title of " Doctor"is already a statutory title in some states, such affect physicians access to training in acupuncture may be negligible but alarming nevertheless. as New Mexico and Rhode Island, in which DOM (in the former) cUrrently, an entry-level doctoral education program in Oriental Medicine or DAc(in the latter)are the only title awarded to licensed and/or Acupuncture is not offcially offered, though the ACAOM has puncturists.Other states permit the usage of titles relating to adopted guidelines for such a program in 2000, which shall consist of 4,000 hours of didactic and clinical training. Although there is much development in acupuncture and Oriental ironically, physicians are otherwise free to practice within their scope of medicine education amongst the professional organizations, acupuncture colleges like Tri-State College of Acupuncture can be ractice, and appropriate training is only recom pected to offer a doctoral program in acupuncture in the near futureTitle Restrictions An interesting development in state restrictions on physicians practicing acupuncture is how the medical acupuncturists may identify themselves and their practice (as described in category “C” above). Montana is a prime example of this position where “A person may not purport to practice acupuncture or use the title ‘acupuncturist’ or any similar title unless the person is li￾censed under the provisions of this [acupuncture statute] chap￾ter.”8 In Rhode Island, where the title “Doctor of Acupuncture” has been awarded to the licensed acupuncturist since 1978, the state Board of Medical Licensure and Discipline allows physi￾cians to practice “Medical Acupuncture as defined by regula￾tions,” but they shall not be considered equivalent to licensed acupuncturists.8 Rhode Island requires that patients receive complete disclosure as to the medical acupuncturist’s training, which must consist of at least 300 hours from a recognized school and a supervised clinical practicum in order to legally practice.8 Finally, in New Mexico, acupuncture is considered to be within the scope of physician practice, but, unless fully li￾censed under the state requirements, physicians are prohibited from using the title “acupuncturist” or any related terms, and even from describing their services as such. New Mexico statute declares, “[other physicians] shall not hold themselves out to the public or any private group or business by any title or descrip￾tion of services which includes the term acupuncture or acu￾puncturist unlessthey are licensed underthe Acupuncture Prac￾tice Act.”8,h Conversely, many states, such as California and Washington, are in a mediating position, where the titles “Dr.,” “OMD,” or “Physician” may be used only when further identifi- cation is explicitly given as to the nature of practice.8 Thus, despite the long-standing rule of the American Med￾ical Association, legal restrictions against “holding oneself out as a medical doctor” through the use of titles may be weak￾ening, as some states begin allowing the usage of titles that directly confer to the acupuncturist the role of a healer in the realm of medicine, and more importantly relay to the lay patient that the acupuncture “physician”8 is a valid and per￾haps insurable mode of medical treatment. As acupuncture continues to be integrated and accepted as a medically valid treatment, it is likely that states will have to respond to the evolving educational mandates set forth by the formal regulating bodies of acupuncture training and certifica￾tion. On the forefront of developments in acupuncture curricu￾lum is the introduction of educational standards for a doctoral level degree program in Acupuncture and Oriental Medicine, through which the graduate is awarded a title of “Doctor of Oriental Medicine.”14 This may pose interesting questions on how states should regulate the usage of the title “Dr.” in practice. Althoughthere are currently no schools offering such a degree,14 thetitle of “Doctor” is already a statutorytitle in some states, such as New Mexico and Rhode Island, in whichDOM(inthe former) or DAc (in the latter) are the only title awarded to licensed acu￾puncturists.8 Other states permit the usage of titles relating to doctor, physician, or Dr. if a doctoral degree is awarded from a recognized college or university.8,i As more universities and colleges of acupuncture and ori￾ental medicine develop and subsequently offer doctoral level programs, a growing body of acupuncture “doctors” may challenge the distinguishing line between the conventional physician of allopathic or osteopathic medicine and the acu￾puncture doctor. It is even debatable whether the standards states set for licensure of acupuncturists and the practicing titles thus granted will change as the ACAOM begins to ac￾credit enough programs at the doctoral level as to eventually replace the masters level training in acupuncture, but it may be “currently premature for states licensing boards to con￾sider basing licensure on graduation from a doctoral pro￾gram,” according to the ACAOM.14,15,j Thus, as the prime route to formal education, as accredited by the ACAOM through the U.S. Department of Education,15,k clinically practicing graduates of such doctoral programs will be in fact doctors or “DOMs” performing, in many (perhaps most) states, acupuncture and Oriental Medicine for the diagnosis, treatment, and prevention of disease. Medical Malpractice: Is This an Issue? Although there have yet to be court cases dealing with mal￾practice in medical acupuncture, there are various issues that need to be addressed in future policy and malpractice ele￾ments particular to the conventional physician practicing acupuncture. It will be interesting to see how courts will handle the issues of standard of care, expert/professional testi￾mony, causative injury, and other elements related to malprac￾tice specific to acupuncture. Shall acupuncture be considered as part of the standard of care as medical communities em￾brace it as a legitimate practice, or will there be a separate standard of care dealing with acupuncture? Who would be the expert witness or authority for medical acupuncturists? For now, there is little authoritative literature describing the application of medical malpractice specifically to comple￾mentary and integrative medicine in general.16 Legal writer Michael Cohen, director of Harvard Medical School’s Legal hIronically, physicians are otherwise free to practice within their scope of practice, and appropriate training is only recommended. i States include Arkansas (DOM if licensed), Hawaii (DAc, Doctor, or Dr.), Massachusetts (PhD/OMD), New Jersey (OMD or PhD), New York (Doc￾tor), Nevada, Utah (Doctor of Acupuncture or Oriental Medicine Doc￾tor), and West Virginia, with subtle variability in exact titles permitted. It is worthy to note, though, that some states have other statutes that prohibit the use of titles according to certain applications, like education. j What more, the ACAOM has proposed to eventually require all ACAOM￾accredited acupuncture training programs to transition to the doctoral program after a 10-year transition period, in effect eliminating the ac￾creditation of Masters degree programs in acupuncture. How this will affect physician’s access to training in acupuncture may be negligible but alarming nevertheless. kCurrently, an entry-level doctoral education program in Oriental Medicine and/or Acupuncture is not officially offered, though the ACAOM has adopted guidelines for such a program in 2000, which shall consist of 4,000 hours of didactic and clinical training. Although there is much ongoing debate over this new development in acupuncture and Oriental Medicine education amongst the various professional organizations, acupuncture colleges like Tri-State College of Acupuncture can be ex￾pected to offer a doctoral program in acupuncture in the near future. Medical acupuncture 27