Prickly Problems in Regulating Acupuncturists

Last spring, it seemed, California had finally straightened out the perennially troubled state Acupuncture Committee, the government panel that regulates California’s approximately 3,500 licensed acupuncturists. On March 2, amid high hopes, five new committee members were sworn in.

Unfortunately, one of them is alleged to have bought the answers to the state licensing examination before taking the test. Two days after his swearing-in, the man stepped down; the state still hasn’t lifted his license or cleared him.

The Acupuncture Committee, a unit of the state Department of Consumer Affairs, has lurched from calamity to farce in this way for years. Few of the 50 state boards, commissions and other bodies regulating California professionals has gone so far wrong.

The irony is that while the state licenses everyone from barbers to paper hangers, often for no good reasons of public safety, acupuncture is one of the things California really ought to be regulating, just like medicine and dentistry. Too bad the regulators have made a mess of it.

“It’s a difficult subject to talk about without slandering someone,” says a disgusted David Wells, president of the California Acupuncture Assn.

At the San Diego-based Center for Public Interest Law, which monitors state regulatory panels, attorney Julianne D’Angelo calls the panel a shambles, adding: “I’m never having acupuncture.”

Trouble at the state Acupuncture Committee goes back to its founding in 1982 and its longtime chairman, Chae Woo Lew, a former San Mateo acupuncturist who allegedly made at least $500,000 selling answers to the licensing test in advance. Lew wasn’t caught until 1988, and although a few dozen guilty acupuncturists were purged as well, it’s by no means certain that the state nailed everyone who, in effect, bought licenses during those years.

“We don’t know how many people are out there practicing acupuncture without having had the qualifications to pass the exam,” said Los Angeles Superior Court Judge Richard Neidorf, who sentenced Lew to five years in prison. The judge also said, “The health and safety of many acupuncture patients has been put at risk for many years to come.”

Nevertheless, says Wells, despite his group’s proddings, the state hasn’t fully investigated. Instead, acupuncturists licensed during Lew’s tenure were required to take an extra 10 hours of continuing education in the field.

The trouble didn’t stop there. After the testing scandal, the Legislature required the committee to find an independent outside firm to run the licensing exam. Last December, the choice of an outside contractor divided the panel so bitterly that four members up and quit.

On April 21, after a long battle marked by allegations of racism and bid-rigging, a reconstituted committee fired Lynn Morris, its chief staff member, an experienced consumer affairs official brought in three years earlier to clean up after the bribe scandal.

The Department of Consumer Affairs says things are finally OK now, but the situation hardly appears settled. Two of 11 seats on the committee remain vacant. Morris’ interim replacement comes from the state Bureau of Electronic and Appliance Repair.

Furthermore, Morris has become a consultant to the Assembly Office of Research, where she’s helping to draft a plan to reorganize the Department of Consumer Affairs. Meanwhile, she says, the regulation of acupuncture in California “is in serious jeopardy.”

Regulating acupuncture isn’t easy under the best of circumstances. As much art as science, it has no universally accepted standards of practice, which means that different acupuncturists may treat a sore elbow with needles stuck in different places. Moreover, scientists don’t agree on how or why acupuncture works.

The licensing exam involves diagnosing larger “syndromes,” rather than Western-style diseases, and some of the world’s best acupuncturists aren’t trained according to Western standards for health professionals.

Many applicants for a California acupuncture license speak so little English that the test is given in five languages. The acupuncturists themselves are somewhat divided along ethnic lines, with separate professional groups for Chinese, Japanese and Vietnamese practitioners.

Aside from the field’s complexity, California’s Department of Consumer Affairs is itself in some jeopardy as state lawmakers struggle to close a budget deficit approaching $11 billion.

As the Acupuncture Committee illustrates, the agency is not the fearless consumer watchdog you may think, and even if it were, cutting it back won’t help much with the deficit.

Professional regulation--of everyone from embalmers to guide-dog instructors--covers nearly a quarter of the state’s work force at a direct cost of $300 million, but the money is raised almost entirely from levies on the regulated practitioners.

On the other hand, those costs are passed along to consumers--and compounded by the anti-competitive effect of erecting huge barriers to new barbers, manicurists and so forth. To the extent that needless licensing is eliminated, the state’s economy and tax receipts will improve.

But acupuncture, an invasive procedure requiring real know-how, is a different story. Maybe if California paid a little less attention to licensing barbers, there’d be a lot less bungling when it comes to needling acupuncturists.