| In testimony before the Little Hoover Commission, former Governor Jerry Brown testified specifically that with his signature on AB 1391 (Torres, 1979) he meant for acupuncturists to be allowed to diagnose their patients, and to use commonly accepted ("western") diagnostic language. |
| Pei Li Zhang, chair of the Acupuncture Board, whose testifimony was interrupted when the Governor arrived, continued her testimony at the Governor's request. She said that, in commonly practiced standards of care, and in the opinion of the Board, that acupuncturists diagnose their patients before treating them, and that the Board had requested that the Legislature add "diagnosis" to statutes, but was rejected. |
| Pei Li Zhang stated: |
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"Currently... our statutes doesn't include diagnosis. There's a lot of confusion, and we need to clarify." |
| Governor Brown replied: |
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"She's right. |
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Of course, when you clarify things, you can also limit what already is the practice. So, once the bill [AB 1391] was signed, that I signed, to remove the physician diagnosis and referral, and enable the acupuncturist to treat the patient directly on his or her own, that, of neccessity, implies diagnosis. You just don't try to treat them unless there is some examination and understanding of the problem of the person in front of you." |
| LHC Commissioner 1: |
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"So that was your state of mind when you signed that bill?" |
| Governor Brown: |
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"Before, in 1975, according to law, you couldn't practice acupuncture without having a doctor refer. A doctor can't refer unless you make some examination and you call a diagnosis. So, once you eliminate the doctor's role, somebody has to look at the person, and there is a diagnosis." |
| Commissioners then questioned whether that was meant to be an oriental medicine diagnosis or a western diagnosis, indicating that they were confused by testimony that contradicted what the Governor was telling them, particularly by testimony given by Dr. Steve Rosenblatt, MD, LAc, who stated that. |
| LHC Commissioner 1: |
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"The question that we have been debating here for at least two days, is this diagnosis a diagonsis in oriental medicine, or is this diagnosis a diagnosis in western medicine? And, if the latter, what would be the ground rules? Should there be a referal to an MD? Or should the acupuncturist, on their own, be able to go in that area? And if that's true, then we'd have a long discussion here this morning as to whether or not the education and/or testing is appropriate for that? |
| LHC Commissioner 2: |
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The question is, is the education acceptable and appropriate for what's presently taking place? |
| Governor Brown: |
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"There's competing individuals and professions for the flow of dollars. This is an economic question. It's a political question. This is cultural, and could be an ideological question. And, I think you should put put the whole medicine business in some context. . . . |
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It is fundamental principle of liberty that people be able to chose the healer of their choice. So, it gets back to a liberty question, it comes to choice. And, depending upon what your choice is, you get different ideological assumptions. . . . |
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Yes, westarn medicine has to be part of the education. You have to deal with a person in front of you with a scientific understanding. . . |
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I think that a certain amount of freedom here, if you allow the profession, that at the end of the day, people will choose what they want. |
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I would say that more education is better than less, and more integration is better than less." |
| After this portion of the Governor's testimony, commissioners asked about when it would be necessary to refer to a medical doctor, and the Governor deferred to the experts in the room. profession |
| Governor Brown: |
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"Okay, so this is the sort of the question. How many millions of people have gone to acupuncturists? And how many tens of thousands of times has it come up that somebody has some malady that has been brought to a western doctor? How is that handled? |
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I assume that it is an everyday component that is being worked through. Maybe some people on the panel could tell us how that works." |
| Dr. Pei Li Zhang: |
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"There is no [diagnostic] language other than biomedical, or biomedicine, that the consumer can understand [and] we are just treating the human body, no matter what kind of patient. The patient's diagnosis never change [and] this diagnosis is the only common use communicated within current [health] care system. |
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Since 1980, acupuncturists have been authorized to diagnose within their current scope and in their daily practice. When a patient is difficult or emergency case, referral to other health care providers is indicated. This could be a specialized diagnosis or treatment that an acupuncturist cannot provide. |
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We do not have any evidence that acupuncturists are not referring when appropriate." |
| Governor Brown: |
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"Thank you." |