September 25, 2003 - Sacramento, CA - Dr. Steve Rosenblatt, MD, LAc, a commissioner of the Accreditation Commission for Acupuncture and Oriental Medicine, provided a very personal account of the history of acupuncture licensure in California which was contradicted by historical fact and again today by testimony from former Governor Jerry Brown.
Continuing his effort to limit California acupuncturists' scope of practice, and to prevent expansion of educational requirements, Dr. Steve Rosenblatt, MD, LAc, and commissioner for the Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM), repeated grossly inaccurate testimony regarding the historical background of acupuncturist licensure in California.
This was the same misleading and inaccurate testimony that Rosenblatt previously gave to a task force of the California Acupuncture Board in 2001 in an effort to dissuade the Board from expanding educational requirements or from acknowledging diagnostic authority, and which, during 2001-2002 legislative hearings, and which found its way into other testimony provided by the California Medical Association (CMA), the Council of Colleges of Acupuncture and Oriental Medicine (CCAOM), the Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM), and other competitors, detractors, and critics of the California acupuncturist profession.
Dr. Rosenblatt's nearly identical testimony to a subcommittee of the LHC the day before (September 24) had been interrupted by a respected elder of the acupuncturist profession, Dr. DaRen Chen, OMD, LAc, who presented copes of the actual 1979 and 1980 legislation, and corrected Rosenblatt's inaccurate statements with those historical facts. The LHC commissioners proceeded pretty much ignored those facts, and continued to give great deference to Rosenblatt and his opinions, rather than to the expertise of others present.
It was quite a surprise to hear Rosenblatt repeat the same inaccuracies in public testimony only a day after he had been corrected. Demonstrating further contempt for the historical record, he allowed his equally inaccurate written testimony to be submitted for the official record.
Rosenblatt had cited legislation (AB 3568, Torres, 1977-78) that he claims to have been personally involved with, and which he claims removed the prior physician referral requirement and had esignated acupuncturists as primary care. In fact, AB 3568 that he referenced had nothing to do with the acupuncturist profession. The bill that actually removed the prior diagnosis and referral requirement (from a physician, chiropractor, dentist, or podiatrist) was AB 1391 (Torres, 1979), and it did not mention "primary care," at all, as Rosenblatt had also claimed.
Further contradicting his testimony was the fact that the removal of the prior diagnosis and referral was quickly interpretted by legal counsel in the Department of Consumer Affairs in the early 1980s to imply that acupuncturists were authorized to diagnose their patients, and that this required western diagnosis to be added to the education and examination requirements.
The following is a copy of Dr. Rosenblatts' written testimony that he provided to the Little Hoover Commission, with inaccurate statements highlighted in red:
August 4, 2003
Re: Proposed Revision of CA Acupuncture Regulations
I would first like to introduce myself. I was one of the first Westerners licensed to practice acupuncture in the United States as I have license number 8 in the State of Oregon which was awarded in 1974. I was licensed as an acupuncturist in California in 1977. I am currently an M.D. licensed in California and Hawaii and board certified in Family Practice. I am currently on the Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM) where I have served for the past 5 years.
I have been asked to serve on the Little Hoover Commission Acupuncture Advisory Committee and I am writing to provide some input to the discussions due to the fact I will be unable to attend the first meeting due to a scheduling conflict.
I would encourage the Commission to undertake a thorough review of the legislative history of California's acupuncture laws to assess the legislative intent in adopting the term "primary care," which has caused significant confusion relative to the scope of practice, educational requirements, and the curriculum hours for licensing acupuncture and Oriental medicine practitioners in the state. The term "primary care" was solely intended to indicate the independent practice of acupuncture, and in no way was it intended to expand the scope of practice relative to western medicine diagnosis and treatment.
Some background on acupuncture legislation in California may be helpful as you consider possible reforms to the regulation of the acupuncture profession:
The first bill enacted regarding the practice of acupuncture was the Duffy-Song Acupuncture Act (AB 976) in November 1972. This bill allowed acupuncture to be performed only under physician supervision in a medical school setting. (On a personal note, I worked with Assemblyman Gordon Duffy on the drafting and passage of this bill and have been active in the development of the acupuncture profession since that time.)
The second piece of legislation regarding the practice of acupuncture was the Moscone bill, which was enacted in 1976. This legislation permitted the practice of acupuncture outside of a medical school setting, but only following diagnosis and referral from a licensed physician or dentist. The bill established the Acupuncture Advisory Committee and provided for the licensing of acupuncturists by the State of California.
A third important piece of legislation was the Torres bill (AB 3568) enacted in 1978 which repealed the provision requiring prior diagnosis and referral from a physician. It was at this time that the term "primary care" was first introduced in acupuncture legislation. The sole intent of the term "primary care" was to designate the "independent practice of acupuncture" without requiring prior diagnosis or referral from a physician. It was in no way intended to change or expand the scope of practice of acupuncture.
I personally worked with Art Torres on the drafting of AB 3568. It was never the intent of this bill that acupuncturists should be trained and able to perform western medicine diagnoses and treatment. Primary care was solely used in this context to designate the independent practice of acupuncture without requiring a prior diagnosis and referral from a physician which was mandated under prior law. This fact was further reinforced in AB 3568 by the specific enumeration of the scope of practice of this newly independent practice.
At the present time, to assert that acupuncturists are educated, trained, and experienced to be able to carry out all the functions of primary care physicians is to misconstrue the intent of the legislation and its defined scope of practice. Acupuncturists are well-trained professionals in the field of Oriental Medicine and are an integral part of the health care delivery system in the State of California. As such they can contribute much to the health and medical care of our citizens. To encourage them to act outside of their area of training and expertise is to potentially endanger the health and welfare of the California consumers.
Please note while I currently serve as an ACAOM Commissioner, the views set forth in this letter are my own, and do not necessarily represent the positions of the ACAOM, which has not reviewed this letter.
Steven Rosenblatt, M.D., Ph.D., L.Ac.
------------------------------
To this day, the Little Hoover Commission keeps Dr. Rosenblatts inaccurate testimony posted on its website, uncorrected.