Medical acupunc ture. The AAMA was initially founded in 1987 by graduates for full membership. Presently no states require such certifi- of UCLA's"Medical Acupuncture for Physicians" training cation, but perhaps the passage of this examination could bo program and now embraces all styles of acupuncture prac- employed as a standard requirement for acupuncture prac tice, 5-element theory, Korean constitutional, Japanese me- tice by physicians in the future. In many cases, membership ridian therapy, electro-acupuncture, etc, under the one dis- eligibility to the AAMa has developed into standard phys tinguishing factor of medical licensure. 16 Standards set forth cian credentialing for physicians in hospital settings, liability for membership are based on the World Federation of Acu- insurance, and reimbursement coverage. It is therefore fore puncture-Moxibustion Societies guidelines for training, 7 seeable that the size and influence of the AAMA will only and the organization itself is presently the sole national pro- continue to influence both the medical and legal environ fessional society in the United States for physician-only acu- ments of medical acupuncture, as more and more regulation puncturists integrates the viewpoints of this professional association, the Statistics from the AAMA reveal an accelerating acceptance general scientifc community, and the tient of acupuncture into the conventional medical communities of allopathic and osteopathic physicians. Beginning with less Conclusion than 50 members in 1987. the AAMA has more than 1800 members with membership doubling every 2 to 3 years. 5A Medical acupuncturists have a definitive role in health care 1997 survey of AAMA members revealed that most were today, utilizing a technique that is a highly adaptable, rela non-specialists in private practice that incorporate acupunc- tively safe, and proven effective Medical acupuncture has the ture into their practice mainly for pain management. 28 1 benefits of integrating both the rigors of biomedical research When asked, physicians claimed that they chose acupunc- and expertise with an ancient knowledge of the bodys un- ture because it is efficacious as a treatment. an alternative in derlying energetic systems to address a more holistic realm of cases of inadequacy of standard medical approach, and because patient care that is becoming more important in health care it offers a"multi-dimensional approach to healthcare. 28 today. Although regulation of non-physician acupuncturists The establishment of a professional organization helps to remains clearly defined and comprehensive in terms of train assuage some of the controversy over the validity of physi ing and licensure, the legal environment of medical acupunc- their medical licen- ture has yet to be formulated beyond being within the scope cians practicing acupuncture as part of their medical licer sure. Competency of medical acupuncturists can at least be of practice of medicine. The main trend within state laws assured through the membership standards of the organiza- governing the medical acupuncturist is one of high variability tion, especially in states lacking any kind of regulation on the and inconsistency across states. Whether a result of the nov- be an active MD or Do licensed to practice in the U.S. or ir cture, or lack of incentive to construct more congruous laws, this confusing network of training requirements and anada;the physician must have completed at least 220 title restrictions only seems to inhibit the acceptance and hours of formal acupuncture training or an apprenticeship refinement of acupuncture by both the medical field and the approved by the Membership Committee; and the physician tific research and more rigorous training requirements across general public. Addressing acupuncture with further scien- must have at least 2 years of clinical experience in acupunc ture. 5, m Additional strata of membership to the AAMA all practicing acupuncturists could unify western biomedi exist for non-practicing physicians, international affliates, cine and traditional Chinese concepts as a more complete and even medical students and residents, demonstrating the and effective system of American health care. Hopefully diverse, growing interest and support of medical acupunc though, increased regulation and quality control of medica acupuncturists does not become so stringent as to limit the ture in the scientific communities, as well as the desire for role physicians have in the deveopment of acupuncture in more formal/authoritative information on acupuncture. nA proficiency examination has also been developed by the Western medicine. Partly because of the relaxed regulatory AAMA as part of a two-part board certification examination, nature of laws regulating physicians in acupuncture, medical but it is unclear whether passing the examination is required acupuncture has yielded innovative applications of acupunc ture in biomedicine. seeding further research and enhanced in the United States is still in this study, a as mailed to 715 members of the AAMA and 312 relatively new field, and thus the legal framework supporting the healing art is rudimentary and anticipatory at best. Con- 12 respondents between the ages of 35-54 years old in private and structing a legal and scientific foundation from which medi- specialty practices. cal acupuncture can be further integrated into physician his 220 hour requirement can be compared to the 300 hours that most practice as not only a complementing but enhancing element states(Georgia, Maryland, New Jersey, New York, and Rhode Island) of patient care is the mission of future policy makers, profes that require training for physicians in order to practice acupuncture Acupuncture programs, on the other hand, must be 3 years in length, sional organizations, and the biomedical community consisting of 1725 hours to be accredited and therefore recognized by References nNote that membership to the AAMA or any professional organization has 1. Accreditation Commission for Acupuncture and Oriental Medicine: many advantageous elements of services, information, and prestige that AccreditationHandbookPartOne,2005.Availableat:http://www. beyond the scope of this paper acaom.org/handbook. htmture. The AAMA was initially founded in 1987 by graduates of UCLA’s “Medical Acupuncture for Physicians” training program and now embraces all styles of acupuncture prac￾tice, 5-element theory, Korean constitutional, Japanese me￾ridian therapy, electro-acupuncture, etc, under the one dis￾tinguishing factor of medical licensure.16 Standards set forth for membership are based on the World Federation of Acu￾puncture–Moxibustion Societies guidelines for training,17 and the organization itself is presently the sole national pro￾fessional society in the United States for physician-only acu￾puncturists. Statistics from the AAMA reveal an accelerating acceptance of acupuncture into the conventional medical communities of allopathic and osteopathic physicians. Beginning with less than 50 members in 1987, the AAMA has more than 1800 members with membership doubling every 2 to 3 years.5 A 1997 survey of AAMA members revealed that most were non-specialists in private practice that incorporate acupunc￾ture into their practice mainly for pain management.28,l When asked, physicians claimed that they chose acupunc￾ture because it is efficacious as a treatment, an alternative in cases of inadequacy of standard medical approach, and because it offers a “multi-dimensional approach to healthcare.”28 The establishment of a professional organization helps to assuage some of the controversy over the validity of physi￾cians practicing acupuncture as part of their medical licen￾sure. Competency of medical acupuncturists can at least be assured through the membership standards of the organiza￾tion, especially in states lacking any kind of regulation on the extent of training or experience of the medical practitioner. Full membership requires three elements: the physician must be an active MD or DO licensed to practice in the U.S. or Canada; the physician must have completed at least 220 hours of formal acupuncture training or an apprenticeship approved by the Membership Committee; and the physician must have at least 2 years of clinical experience in acupunc￾ture.11,15,m Additional strata of membership to the AAMA exist for non-practicing physicians, international affiliates, and even medical students and residents, demonstrating the diverse, growing interest and support of medical acupunc￾ture in the scientific communities, as well as the desire for more formal/authoritative information on acupuncture.11,n A proficiency examination has also been developed by the AAMA as part of a two-part board certification examination,2 but it is unclear whether passing the examination is required for full membership. Presently no states require such certifi- cation, but perhaps the passage of this examination could be employed as a standard requirement for acupuncture prac￾tice by physicians in the future. In many cases, membership eligibility to the AAMA has developed into standard physi￾cian credentialing for physicians in hospital settings, liability insurance, and reimbursement coverage.2 It is therefore fore￾seeable that the size and influence of the AAMA will only continue to influence both the medical and legal environ￾ments of medical acupuncture, as more and more regulation integrates the viewpoints of this professional association, the general scientific community, and the patient. Conclusion Medical acupuncturists have a definitive role in health care today, utilizing a technique that is a highly adaptable, rela￾tively safe, and proven effective. Medical acupuncture has the benefits of integrating both the rigors of biomedical research and expertise with an ancient knowledge of the body’s un￾derlying energetic systems to address a more holistic realm of patient care that is becoming more important in health care today. Although regulation of non-physician acupuncturists remains clearly defined and comprehensive in terms of train￾ing and licensure, the legal environment of medical acupunc￾ture has yet to be formulated beyond being within the scope of practice of medicine. The main trend within state laws governing the medical acupuncturist is one of high variability and inconsistency across states. Whether a result of the nov￾elty and uncertainty towards the discipline of medical acu￾puncture, or lack of incentive to construct more congruous laws, this confusing network of training requirements and title restrictions only seems to inhibit the acceptance and refinement of acupuncture by both the medical field and the general public. Addressing acupuncture with further scien￾tific research and more rigorous training requirements across all practicing acupuncturists could unify western biomedi￾cine and traditional Chinese concepts as a more complete and effective system of American health care. Hopefully, though, increased regulation and quality control of medical acupuncturists does not become so stringent as to limit the role physicians have in the development of acupuncture in Western medicine. Partly because of the relaxed regulatory nature of laws regulating physicians in acupuncture, medical acupuncture has yielded innovative applications of acupunc￾ture in biomedicine, seeding further research and enhanced patient care. But acupuncture in the United States is still a relatively new field, and thus the legal framework supporting the healing art is rudimentary and anticipatory at best. Con￾structing a legal and scientific foundation from which medi￾cal acupuncture can be further integrated into physician practice as not only a complementing but enhancing element of patient care is the mission of future policy makers, profes￾sional organizations, and the biomedical community. References 1. Accreditation Commission for Acupuncture and Oriental Medicine: Accreditation Handbook, Part One, 2005. Available at: http://www. acaom.org/handbook.htm l In this study, a survey was mailed to 715 members of the AAMA and 312 responded for the analysis of the data. Results showed that there were 312 respondents between the ages of 35-54 years old in private and specialty practices. mThis 220 hour requirement can be compared to the 300 hours that most states (Georgia, Maryland, New Jersey, New York, and Rhode Island) that require training for physicians in order to practice acupuncture. Acupuncture programs, on the other hand, must be 3 years in length, consisting of 1725 hours to be accredited and therefore recognized by most states. nNote that membership to the AAMA or any professional organization has many advantageous elements of services, information, and prestige that are beyond the scope of this paper. Medical acupuncture 29