* understand the evolution of different systems of medicine such as Kampo and Tibetan medicine that developed from Chinese culture, and the philosophical basis of these systems.
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1980: Definition of acupuncture expanded to include additional TOM modalities, including herbal medicine, in CA (electroacupuncture, cupping and moxibustion, oriental massage, breathing techniques, exercise or nutrition, “drugless substances and herbs as dietary supplements)
According to one acupuncturist active in promoting the professionalization of AOM, on of the major barriers to the development of acupuncture are professional acupuncturists themselves. He informed me of three major professional AOM organizations, which are differentiated along ethnic/national lines: Chinese acupuncturists, Korean Acupuncturists, and “American” acupuncturists. The third group tends to attract second generation Chinese American acupuncturists, as well as first generation immigrants from non-Asian countries who have become acupuncturists (e.g., from my study alone = Israel, Brazil and the UK).
§205.254. RENEWAL OF EXPIRED LICENSE BY OUT-OF-STATE PRACTITIONER.
§205.253. PROCEDURE FOR RENEWAL.
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The committee is composed of 11 members: 5 acupuncturists with at least five years of acupuncture experience and not licensed as physicians, 2 licensed physicians with two years of acupuncture experience, and 4 public members. The Governor appoints the seven practitioner and two public members who are subject to Senate confirmation, and the Senate Rules Committee and the Assembly Speaker each appoint one of the two remaining public members. Committee members are appointed to a term of three years. Currently there is one physician board member vacancy which has persisted for a number of years - apparently indicating a difficulty in finding a satisfactory candidate with the requisite acupuncture experience to serve on the board.
§205.252. NOTICE OF LICENSE EXPIRATION.
Before acupuncture became regulated in California acupuncturists could be arrested and prosecuted for engaging in the unlicensed practice of medicine. As a result, acupuncturists and their patients organized and sought regulation to make the practice of acupuncture by acupuncturists legal.
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TCM has four main components: acupuncture, herbal medicine, tui na, and qi gong. Herbal medicines are generally delivered in compound formulas specially formulated for a clinical syndrome or constellation of symptoms. Tui na is the ancient Chinese massage used for lymphatic drainage and muscle rejuvenation. Qi gong is the practice of energy movement in the body through physical movement.
My dissertation is about the relationship between acupuncturists and their patients during the treatment session. I conducted in depth open ended interviews with 12 acupuncturists (8 of whom became full participants in the study). I have also had informal conversations with many acupuncturists, at least three of which have influenced my thinking about this topic. The initial purpose of the interviews was for me to establish rapport with the acupuncturists and learn about things that might influence their participation in the interactions that I video taped. In the interviews I asked about how they decided to become acupuncturists, their educational history and experiences, what it is like to be an acupuncturist in the US, how they run their practice, their relationships with their patients, and how they see acupuncture/AOM fitting into American health care. The parts of the interviews that seem to be most relevant to this paper is the part where they talk about their education, but some issues surrounding licensing and practice my be relevant, too.
Exemptions: Physicians licensed by the Medical Board of California are authorized to practice acupuncture within their scope of licensed medical practice, with or without acupuncture training. Podiatrists licensed by the California Board of Podiatric Medicine and dentists licensed by the Board of Dental Examiners may also practice acupuncture as part of their respective licensed practices - if they have completed a course of instruction in acupuncture approved by their respective licensing boards. Further, the Acupuncture Act does not prohibit non-licensed persons from performing or prescribing oriental massage, breathing techniques, exercises, or nutrition to promote health so long as those activities are not performed or prescribed in connection with the practice of acupuncture.
Improvements noted by the Committee over the past few years have included: (1) Adoption of a Strategic Plan with goals and performance objectives; (2) Performance of an occupational analysis for the licensing examination in 1996; (3) Establishing a system to perform random audits for continuing education compliance; (4) Making changes in the administration of its practical examination in response to numerous complaints, and contracting with a new examination contractor to revise and administer that examination; (5) Anticipated elimination of one portion of the clinical examination (clean needle technique) as no longer necessary beginning next year; (6) Proposing, through regulation, the upgrading of the Tutorial Program to make it more equivalent to the current formal educational requirement for acupuncture school training.
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Acupuncture is a component of the health care system of China that can be traced back for at least 2,500 years. The general theory of acupuncture is based on the premise that there are patterns of energy flow (qi) through the body that are essential for health. Disruptions of this flow are believed to be responsible for disease. Acupuncture is used to correct imbalances of qi flow at identifiable anatomical locations on and just below the skin, the acupuncture points, by the stimulation of a variety of techniques. The most studied mechanism of stimulation of acupuncture points employs penetration of the skin by thin, solid, specially tipped, metallic needles, which are manipulated manually or by electrical current. There are a variety of approaches to diagnosis and treatment in American acupuncture that incorporate medical traditions from China, Japan, Korea, Tibet, Vietnam, and France.
Kampo continues to be practiced extensively in Japan, as well as in America and other countries. Tibetan medicine has considerably less adherents than either TCM or Kampo. However there is increasing interest in certain herbal formulas for the management of cancer.
(b) In establishing standards for the entrance requirements and course of instruction of an acupuncture school, the acupuncture board may consider the standards set by the National Accreditation Commission for Schools and Colleges of Acupuncture and Oriental Medicine.
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