Acupuncture Test Scandal Is a Painful Regulatory Lesson

In a stuffy downtown Los Angeles courtroom, an assortment of lawyers, investigators and Korean translators convened last month to begin unraveling an odd tale of intrigue and alleged corruption in the world of acupuncture.

The testimony has read like a spicy thriller, replete with a clandestine rendezvous in a Koreatown restaurant, electronic bugging devices, secret code words and an envelope fattened with $15,000 in cash allegedly to bribe a state acupuncture official.

The prosecution of the official, Chae Woo Lew, on charges of taking as much as $500,000 to rig the state licensing exam has turned a spotlight on the way California has overseen the burgeoning business of traditional Asian medicine.

At the heart of the scandal is a little-known state agency, the California Acupuncture Examining Committee, whose 11 members, mostly acupuncturists, control nearly every aspect of acupuncture in the state, including education, licensing and discipline.

Many acupuncturists, some committee members and others in related fields complain that the board has operated for years with little accountability or oversight despite nagging complaints of corruption.

A handful of committee members run the state licensing examination personally--writing, translating, administering and grading it--a practice that so irked state legislators, they intervened last week to try to force the committee to hire independent testing consultants.

The committee members have offered the exam only once a year, despite repeated requests that it be given more frequently. Students who fail--and there have been many--have had no avenue of appeal or of learning what they did wrong.

Now prosecutors say Lew, once viewed as the committee’s most powerful member, sold the exam answers for fees of up to $27,000. The scheme functioned unchecked, prosecutors said, for six years, despite repeated complaints that the system was flawed.

Twenty-four acupuncturists have pleaded guilty in connection with the scandal. Twenty-three others await disposition or are believed to have fled the country. Law enforcement officials are exploring whether more people were involved.

The top staff member of the acupuncture committee resigned under pressure, effective Saturday. Legislators briefly threatened to cut off the board’s funding. One dissident committee member, Joel Edelman of Santa Monica, argues that the group “has forfeited its right to exist.”

‘No Checks and Balances’

“It’s shocking to see that there was actually this much corruption in one small, little board,” said William G. Devine, an acupuncturist in Thousand Oaks and chairman of the California Acupuncture Assn. “There were no checks and balances.”

The chairwoman and the executive officer of the examining committee did not return repeated telephone calls from The Times requesting interviews for this story. Several newer members who agreed to talk urged patience, saying reforms are in the works.

In response to public pressure, the committee has made changes in the once-notorious exam. It has also been developing a process by which students may appeal their exam results. Chae Lew has left the board, and other longtime members are not seeking reappointment when their terms expire.

On Thursday, the Assembly passed by a vote of 66 to 1 a bill that not only would take absolute control of the exam away from the committee, but would also alter the committee’s composition and make it possible to expel members for misconduct.

“My concern is, ‘Don’t let it happen again, don’t let this shame happen again,’ ” said David Y. C. Chen, a Whittier acupuncturist who joined the committee on Jan. 1. “The fact is, the problem happened. Let’s do something to prevent that from happening again.”

Expected to Police Selves

Some observers, however, contend the acupuncture committee’s problems may be endemic to the state’s regulatory system, in which appointive boards of unpaid professionals, ranging from accountants to veterinarians, are expected to police their own profession.

“You don’t want the fox watching the henhouse,” remarked Sen. Herschel Rosenthal (D-Los Angeles), a critic of the acupuncture committee. “It seems to me that nobody is going to blow the whistle on somebody who belongs to the same club.”

About 3,400 acupuncturists are licensed in California to practice the traditional form of Asian medicine, in which needles are inserted in patients’ skin as therapy for a wide range of conditions ranging from chronic pain to addiction, depression and anxiety.

Precisely how acupuncture works remains unclear--and some Western physicians doubt whether it works at all. But research suggests it may cause the release of morphine-like substances called endorphins, which serve as natural pain killers.

California is home to 14 licensed acupuncture schools, regulated by the committee and the state Department of Education. Over the last two decades, new laws have expanded acupuncturists’ rights to treat patients without physician referral and to be reimbursed by insurers.

‘Sets Pace for Country’

“We have the largest population of acupuncturists in the country,” said Loisanne Keller, a licensed acupuncturist practicing out of a small office in West Los Angeles. “What happens here, many of us feel, sets the pace for the country.”

Several hundred thousand Californians are estimated to have had acupuncture treatment.

The examining committee came into existence in 1982, six years after California officially legalized acupuncture and began licensing practitioners. By law, the membership must include seven acupuncturists, two physician-acupuncturists and two members of the general public.

Nine of the members are appointed to their three-year terms by the governor, the other two by the Speaker of the Assembly and the Senate Rules Committee. Selections are based on a mix of qualifications and political ties, participants and officials say.

Chae Lew, for example, was a major contributor to Gov. George Deukmejian--more than $9,000 in 1986 alone, according to state records. Several other members have contributed smaller amounts to Deukmejian and various state legislators, records show.

Influence Credited

“Whoever is the most active in the political field and gets the influence of the governor’s office will be appointed,” said Daren Chen, chief of the political action committee of the California Certified Acupuncturists’ Assn. “That’s why we Chinese (who are) usually very active . . . have a bigger influence than other groups.”

Five of the current members are Chinese-Americans. Korean-Americans are not represented. No California-trained acupuncturist has ever been appointed to the committee, although they are believed to make up nearly half the licensed practitioners in the state.

“This is what’s wrong with this country,” said Mohammad Mosleh, the Iranian-born dean of Emperor’s College of Oriental Medicine in Santa Monica. “People are appointed based on how they’re connected, not based on qualifications.”

Bob Fellmeth, head of a San Diego-based public-interest law group that monitors the state’s appointive boards, said, “You’re creating a nice atmosphere for people who have a profit stake in the public policy to control the policy--for all of us.”

The bribery scandal broke Jan. 20, with the arrest of 53-year-old Lew at a hotel near Los Angeles International Airport. Authorities say Lew was carrying a $30,000 down payment intended to persuade a Koreatown newspaper reporter-turned-informant to leave the state.

56-Count Complaint

One month later, the Los Angeles County district attorney’s office filed a 56-count criminal complaint against Lew. It accused him of taking hundreds of thousands of dollars in bribes between 1982 and 1988, and then paying people to cover up the scheme.

During a cantankerous preliminary hearing in June in Los Angeles Municipal Court, a bevy of informants and alleged co-conspirators sketched out how Lew allegedly received money from students in return for clues that would enable them to pass the exam.

One witness, Hyun Chul Jun, said his role was to offer “special tutoring sessions” at a San Francisco motel. There, Jun said he gave the students test questions picked up earlier from Lew, and coached them on the answers.

Later, Jun said, he arranged a meeting between Lew and a handful of students at a Koreatown restaurant. The students presented Lew with an envelope stuffed with $15,000 in return for a list of certain code words that would appear on the exam, signaling correct answers.

Another witness, Kim Sang Suk, a Koreatown newspaper reporter, said in court testimony and interviews that he worked as an informant for the district attorney’s office. While Kim wore a hidden microphone, Lew allegedly promised him a total of $50,000 to relocate to Hawaii and to dodge a subpoena in the case.

Says No to Interviews

Lew, whose wife, Hai Ja, has also been charged, turned down repeated requests to be interviewed by The Times. Lew’s lawyer also declined. If convicted on all counts, Lew could face a maximum of eight years in prison and $10,000 in fines.

The corruption charges came as no surprise to many acupuncturists. There had long been complaints that the exam was “for sale.” Students had complained to the committee and the state attorney general’s office, which investigated but failed to prove the allegations.

A small subcommittee, headed by Chae Lew, had written the exam. Lew himself had personally translated the Korean version. That practice contrasted sharply with that of other state boards, many of which work with outside consultants or use national tests.

In recent interviews, acupuncturists described the exam as capricious and subjective. They said they were asked to make diagnoses under impossible conditions, and were graded on techniques on which acupuncturists of different training often disagree.

Once students failed, they said, they had little recourse. There was no appeals process and they were unable to see their tests. Some students who failed were forced to postpone their acupuncture careers for a year while they waited to retake the test.

Impossibilities Prevail

“The bottom line is that the secrecy, combined with the totally subjective nature of the scoring, makes it impossible for people to ascertain whether their exam has been fairly graded,” said Sue Ochs, a San Francisco lawyer who is suing the committee.

“I always assumed that whatever problems there were with the examination were problems of judgment, not of legality,” said Ochs, who represents a group of acupuncturists. “It never occurred to me that they might be manipulating the exam.”

Equally controversial has been some committee members’ behavior. Acupuncturists describe members as hostile, secretive and unresponsive. Devine said his association, the state’s largest, was long unable to obtain even a list of the members’ names and addresses.

Christopher Crotty, an aide to Assemblywoman Lucy Killea (D-San Diego), said he has helped acupuncturists file complaints with the committee and received no response. Sen. Rosenthal said he surveyed 45 acupuncture groups and schools and found widespread dissatisfaction.

Edelman, a lawyer and mediation specialist whose term on the committee ended Friday, also doubts the group’s neutrality. For example, he recently questioned the appropriateness of members accepting dinners paid for by acupuncture associations.

“These banquets are indicative of an atmosphere and a state of mind which seems to pervade the AEC,” Edelman wrote March 20 to Assembly Speaker Willie Brown. “There seems too little sensitivity to the distinctions between the regulators and the regulated.”

Many of the criticisms of the committee came to a head two years ago, after the September, 1987, practical exam. Students began organizing statewide and traveling to Sacramento to complain. One group sued the committee in Superior Court in San Francisco.

Rosenthal introduced legislation requiring that an independent testing company conduct the exam, and that an appeal process be set up. The bill passed but was vetoed by Deukmejian on grounds that it allowed insufficient time to make the required changes.

Amid the furor, Edelman pushed for a special committee task force on the exam. It held two public hearings in San Francisco and Los Angeles early last year. Hundreds of angry students, acupuncturists and school officials turned out and bitterly complained.

But when the task force report surfaced on the committee’s April, 1988, agenda, the chairman removed it, on advice of counsel, in light of the newly filed lawsuit. Though some of the recommendations are now in place, the findings were never aired publicly.

‘Passive Body’

“The committee as a whole has really been a very passive body and it’s really acquiesced to intimidation,” Edelman charged in June in testimony before a legislative subcommittee. “There’s been a suppression of public discussion of real reform.”

Now critics say the committee has reacted to the bribery charges with an equal lack of urgency, prompting a handful of frustrated legislators to threaten briefly both to withhold the committee’s 1989-90 budget and to disband the body if reforms are not made.

On Thursday, the state Assembly passed a bill introduced by Assemblyman William J. Filante (R-San Rafael) requiring, once again, that independent consultants administer the exam and the state Department of Consumer Affairs oversee and approve the process.

The bill, which now goes to the Senate, would allow acupuncturists to be appointed to the committee with just five years’ experience, rather than the 10 currently required. That provision would make more California-trained practitioners eligible for appointment.

The bill would also require that the committee’s membership reflect the “cultural background” of all licensed acupuncturists--a provision aimed at correcting past imbalances and answering complaints that Caucasian acupuncturists have been shut out.

Deeper Questions

Whether or not the bill passes, some observers say the scandal raises deeper questions about the state’s reliance on appointive boards--not just the 10 committees overseeing allied health professions like chiropractic and podiatry but more than 30 others.

While defenders of the system say that there is no one as qualified as an acupuncturist to understand the intricacies of the profession, critics contend that any professional has little incentive to vigorously police his or her own specialty.

“Our big dream is not to have anyone on a board who is of the profession,” said Julianne D’Angelo of Fellmeth’s Center for Public Interest Law. “They’re making disciplinary decisions that affect their competitors. It’s astounding to us that this still goes on.”