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I asked the Federal Trade Commission to investigate the Acupuncture Certification Commission for their monopoly

Originally posted to the Prick, Prod, Provoke Blog on the People’s Organization of Community Acupuncture (POCA) website

My fellow Acu-punks,

In July, I attended a Zoom meeting held by our Federal Trade Commissioners. I had one minute to tell them why I wanted them to investigate the National Certification Commission of Acupuncture and Oriental Medicine (NCCAOM). In a nutshell, I spoke about their anti-competitive practices and consumer monopoly over the national certification of acupuncturists.

I want you to join me in this effort. All you need to do is send an email. Personal stories are optimal, but if you don’t know what to say, Jersey Rivers and I have taken care of that for you. (More on that below.)

Why am I asking you to do this? It’s because I don’t know what the NCCAOM is. I mean that sincerely. Are they a certifying body, creating a test of acupuncture competency to ensure public safety? Or are they a trade association, bringing acupuncturists together to advance their common business interests through lobbying and public relations campaigns? What they really seem to be doing is advancing the interests of the NCCAOM.

According to the Cause IQ website The NCCAOM is listed as a professional association. Which means that in my state, and many others, acupuncturists are required by law to pay a trade association to renew our state licenses long after we passed their exams. You can see from the website that Chief Operating Officer, Mina Larson, makes almost $205,000 a year. This isn’t as much as the outgoing COO, Kory Ward-Cook, whose outgoing salary was around a quarter of a million dollars a year. This Wikipedia article defines what trade associations do. Providing certification (and re-certification) is not one of the things. At the state level, the entity that provides your state’s acupuncture license is not the same as a membership based acupuncture professional association. Those two things should not overlap at the state level, so why do they overlap at the national level?

The California exam is known for being more rigorous than the NCCAOM’s exams. Shouldn’t this mean that California certified practitioners are eligible for licensure parity in any other state? One would think. For the time being, most states require acupuncturists to have taken the NCCAOM exams. Even acupuncturists that live in states that do not require continuous recertification with the NCCAOM as a condition for renewing a state license, will stay current with the NCCAOM in order to obtain a license in another state. We need acupuncture licensing boards to clean up state laws and make licensure reciprocity much easier.

California acupuncturists are working to accept the NCCAOM exam in their states. I think we all agree that this is a good thing. But they are forced to do so. Otherwise, California acupuncturists who are not NCCAOM certified are not eligible to apply for federal jobs in their own state. By federal law, NCCAOM certification is required in order to work for the Veterans Administration and other federal facilities. The NCCAOM lobbied Congress for this shitty policy. Our recertification fees provided the funds for them to do so.

There are many ways to practice acupuncture. The NCCAOM exam focuses on TCM. This discriminates against Five Element practitioners and other lineages and styles of acupuncture. The founders of People’s Organization of Community Acupuncture had a long term vision for an alternative exam that would focus more on acupuncture safety, less on theory. Maybe that exam, and all the extra fees that go with it, won’t cost $2000.

President Joe Biden feels the same way that I do. He wants the Federal Trade Commission to boost the labor market by cutting burdensome red tape surrounding professional licensure and support portability of state licenses. Biden put Lina Kahn, an Antitrust Legal prodigy, in charge of the FTC. Because of Khan, the FTC has monthly open meetings. They invite the public to make comments, like I did. They offer the options to submit comments by video* or email.

Acupuncture in front of the NH State House in 2017. Photo credit: Eric Zulaski

We could have a shot at this if we get involved and ask acupuncturists beyond POCA to get involved. The FTC may be able to do something about the NCCAOM if enough of us can push them to act. But, be warned, if you want fairness in licensure reciprocity you will have to start talking to lawmakers in your own states.

Are you with me? You can also write a letter sharing your own story of how NCCAOM’s anti-competitive practices have made it hard for you to practice acupuncture or get a job at a federal facility. That would be ideal. OR just copy, paste, and don’t forget to personalize the letter below to antitrust@ftc.gov.

If you want to read more about antitrust, you can check out the FTC’s website: https://www.ftc.gov/faq/competition/report-antitrust-violation

Sincerely, Elizabeth Ropp, Diplomate of Acupuncture and Traditional Medicine (NCCAOM)

* If you would like to speak at a meeting with the FTC or submit a video, talk to me. I can help you make that happen. Email me at arunareiki@gmail.com

Dear Federal Trade Commissioners,

(Introduce yourself, name, where you live, how long you have been practicing acupuncture)

My colleagues and I are writing to inform you about the anti-competitive practices of the National Certification Commission of Acupuncture and Oriental Medicine (NCCAOM). According the to Cause IQ website, they are listed as a business and professional association. However, they act as the acupuncture profession’s gatekeeper by offering the only national certification exam for acupuncture and herbal medicine. From their website: “Established in 1982, NCCAOM is the only national organization that validates entry-level competency in the practice of acupuncture and Oriental medicine (AOM) through professional certification.”

All but four US states use or require the NCCAOM Exams for initial licensure; roughly half of the state laws require ongoing credentialing from practitioners, which means that, in addition to state licensing fees, we must pay the NCCAOM to maintain current status every four years, long after we have passed their exams. Even though we are subject to an expensive national credentialing requirement, we do not enjoy license portability across state lines. Our relationship with the NCCAOM is all cost, no benefit, and absolutely mandatory if we wish to legally practice our profession.

NCCAOM functions with no oversight in terms of fees or their lobbying efforts in Washington, DC, or at the state level. Over time, their lobbyists have expanded the NCCAOM’s scope of influence to have more and more states: 1. Require their exams; 2. Require ongoing active diplomate status; 3. Require their Herbal Medicine exam in addition to the three others most states require. The only oversight provided by the NCCA, their accrediting body, relates to testing content. While I believe that tests are necessary for public safety, the costs (and content) of the NCCAOM exams contribute to the high cost of entering the acupuncture profession and do very little to protect the public.

I would like to ask the FTC to review the practices at the NCCAOM and initiate changes that will reduce their power to create barriers to entering and continuing practice as a licensed acupuncturist.

Signed,

(Your name here)

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