On Getting Respect from MDs

span style="font-size:small;">I have to wonder what planet the L. Acs live on who think that the FPD with one more year of WM classes will put them on “equal footing” with the MDs and get the respect from MDs that they crave.

span style="font-size:small;">You have to appreciate that the education for an MD is 4 years of college, 4 years of medical school and at least 3 years of a residency.That’s at least 7 years beyond a bachelor degree that was heavily weighted in sciences and math.

span style="font-size:small;">Some of our schools allow those with 2 yrs of college from any field to enter.We get 3-4 years in the masters programs.Add one year and we have maybe 5 yrs.Looks about equivalent, huh?

span style="font-size:small;">Let me just put it to you this way.The MDs look at anyone else in the health field, regardless of their degree, the way the majority of the L. Acs look at the training DCs and MDs get in their little acupuncture courses.In other words, the L. Acs are smug in the knowledge that they know WAY more than those who take a 100-350 hr course in acu and unless the MDs/DCs get the same acu education we do, L. Acs WILL NEVER GIVE THEM THE SAME RESPECT.It’s the same for any group who had the most advanced training in a field.I’ve been in nursing for 40 years and even the nice, open-minded MDs who want to be called by their first names have this attitude.And why not?They know way more WM.

span style="font-size:small;">I got some very humbling lessons when I was a family nurse practitioner at a WM community clinic and thought I was “nearly equal” to the MDs.Over and over they put me in my lower place.It was also quite clear to me that even after 35 or so years as a nursewith a critical care background, my 7 month FNP training beyond my nursing masters didn’t prepare me to talk about WM on a level respected by MDs.No way one year of added biomed will give L. Acs “equal footing” or the knowledge to talk as equals with the MDs.They simply know more WM and they know it.

span style="font-size:small;">You can take this to the bank.

span style="font-size:small;">However, I do know several MDs that highly respect the AOM that L. Acs know.They send patients to me.One even sent her daughter to me after WM had given up on her.And my humble CA style acupuncture is well on the way to getting her daughter well.Raw herbs prescribed by the expert at the local school will accelerate her healing. A very well respected neurologist in town had lunch with me a few years ago and told me that he knew his 350 hr MD acu course didn’t hold a candle to my master’s education in AOM and he would be referring patients to me.He does.And they usually get better with acu alone with me educated at a master’s level.

span style="font-size:small;">You can also take this to the bank.

span style="font-size:small;"> 

span style="font-size:small;"> 

This story was posted on December 3 2009 by annmongeau.
Tags: fpd

Comments

  • December 4 2009 at 12:56 AM
    bmiller writes:

    Yep

    I agree entirely.

    Yesterday I went to meet an old friend from high school and catch up on what we have been doing for the past 10 years. She is an OB/GYN. She told me that she refers lots of patients to an acupuncturist for fertility issues and said it does wonders for her patients. We started talking about acupuncture school and she was shocked at how much WM we have to do. She could not understand why. I told her we take classes like Physics and BioChem. She asked why and I told her it is because the acupuncture profession wants desperately to be accepted by western medicine and we shared a laugh.

    She had no idea what our education consists of and did not really care. She just knew that acupuncture works for her patients and that is all that she cared about. 

    If we want respect from MDs we need to see lots of patients and help them get better.  

      0 likes
  • December 4 2009 at 8:06 AM
    Jessica Feltz writes:

    Bingo.

    “The MDs look at anyone else in the health field, regardless of their degree, the way the majority of the LAcs look at the training DCs and MDs get in their little acupuncture courses.”  That is the perfect analogy, Ann. 

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  • December 4 2009 at 2:53 PM
    acuguy writes:

    Just learn to talk good.

    I know a great shortcut for anyone who wants to impress
    M.D.s with their knowledge of Western medicine; just learn your Medical
    Terminology really well. More than anything, the language of medical
    terminology denotes your level of education in the medical establishment’s
    eyes. It is kind of like how language separates the classes among the British. Only
    lower class people use the word “mirror.”  To the upper classes the term is “looking
    glass.” The same happens in Western medical circles. Learn your Latin roots
    well and you will be able to talk real good like a real doctor.

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  • December 4 2009 at 6:42 PM
    annmongeau writes:

    Sure, you betcha

    I think you have your tongue in your cheek, but just in case you believe that, I’ve got a great bridge to no where for sale you might be interested in.

      0 likes
  • December 5 2009 at 12:26 AM
    Lisafer writes:

    bridge to nowhere

    you mean the FPD, right?

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  • December 5 2009 at 11:37 AM
    annmongeau writes:

    Yup

    smile

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  • December 5 2009 at 7:48 PM
    Guest writes:

    I see some very valid points

    I see some very valid points in your post, annmongeau. I have met physicians who have great respect for AOM, physicians who have LAc’s on staff, who refer out consistently, etc… I also understand what you mean about the preparation involved when getting a specific degree and that WM is heavily inundated with science and math. I understand what the lifestyle entails and the amount of knowledge that is obtained is to be respected, just as the mavens of AOM, we are to be respected for what we know. These are all very good points. Your point would be even more salient if it actually applied to what supporters of the FPD are actually saying. But it doesn’t.

    I want to bring attention to some of the presumptions that exist there in your argument. I wish to do this because I see this as a certain theme here on CAN- that LAc’s who support an FPD are insecure and “crave” respect from the Western Biomedical establishment. This is a misconception of intentions and frankly an easy one to make because it makes good fodder for blog posts where the choir can then cheer on. But I have to point out- this is all too easy a strawman to construct. If you take this idea of “being on equal footing” and then extrapolate from there that all FPD supporter are just “insecure” and assume that this means we want to parade around some superficial knowledge of biomedicine as if it is worthy of the depths of Western training, well then I see your point. But the problem is that you have taken this concept of “being on equal footing” and twisted its meaning as well as the intention behind it. Thus, the strawman I mention.

    You said you wonder what planet we are on?  Well, when you assume that FPD supporters have CONFLATED some idea of AOM and Biomedicine education as being the same, well I would wonder also. But your presumptions are out of line. Again, I can see the opportunistic drive at work here- if we just label FPD supporters as insecure biomedical wannabes than we can parade around all day denigrating that so called “insecurity” and use it as fodder for our rhetoric. Sorry but I don’t buy it.

    The FPD is a move toward strengthening our profession in the greater cultural context. This means we are expected to be educated in some aspects of biomedicine and integrative techniques. This is about creating and strengthening OUR OWN IDENTITY within the environment we live. I am always taken aback by those who say- haha isn’t it funny that we have to take science and physics to participate in this healthcare system? Um, yeah. This kind of delineation of science vs. AOM is ridiculous. You have created a binary mindset here that is deceptive and inappropriate. Science is not the enemy nor is it in the more benign sense ‘useless for our profession’ . You all need to get over this.

    I also want to point out what I see as the undercurrent of your post. Ironically I see a lot of insecurity. It is evident even in the language you use. It is especially evident in this paragraph you wrote:

    ‘I got some very humbling lessons when I was a family nurse practitioner at a WM community clinic and thought I was “nearly equal” to the MDs.  Over and over they put me in my lower place.  It was also quite clear to me that even after 35 or so years as a nurse with a critical care background, my 7 month FNP training beyond my nursing masters didn’t prepare me to talk about WM on a level respected by MDs.  No way one year of added biomed will give L. Acs “equal footing” or the knowledge to talk as equals with the MDs.  They simply know more WM and they know it.’

    _Over and over they put you “in your place”?

    _35 years+ of nursing and an FNP and you couldn’t interface with an MD with some measure of respect?

    _No way we can ever “talk as equals with MDs”?

    Who is insecure here? And please do not say again how MD’s are on another planet somehow. They are human beings just like us. Yes, human beings with a vast amount of training but you elevate the MD so much as to exclude yourself and anyone else from being capable of having a respectful interaction? I don’t buy it. If you have a working knowledge of medical terminology and some sense of diagnostic techniques you can certainly have a conversation with an MD. Its not about one-up-manship here, it is about having a working dialogue that benefits the patient. You conflate the two.

    I have taken what you have said to the bank, and it doesn’t wash. Why? Because your opinions are based on a trajectory of assumptions, assumptions that lead you to ask what planet we are from? You don’t have to be a supporter of the FPD, that’s not what I’m getting at. But please tone down the your weakened version of what claims to be someone else’s intention.

    I understand my position is unique here so I expect there to be a veritable hornets nest of replies trying to put me in my proverbial place.

    But you all need to examine your assumptions and extrapolations. Its a nice thing to be right,  to feel good about yourself based on your opinions, but sometimes those opinions are dead wrong.

      0 likes
  • December 5 2009 at 9:48 PM
    LarryG writes:

    ?

    you wash things at the bank?

      0 likes
  • December 5 2009 at 9:59 PM
    keithananda writes:

    ever play the card game bullshit?

    You write:

    “But you all need to examine your assumptions and extrapolations. Its a
    nice thing to be right, to feel good about yourself based on your
    opinions, but sometimes those opinions are dead wrong.

    The FPD is based on a trajectory of assumptions.  We’re calling bullshit.  Simple as that.

     

      0 likes
  • December 5 2009 at 11:58 PM
    andy wegman writes:

    Here’s the crux of the problem…

    “The FPD is a move toward strengthening our profession in the greater cultural context.”

    The greater cultural context in who’s opinion? 

    The tone of your writing suggests a position of authority with respect to the FPD. If this is true, what strikes me as most disheartening, would be the stark disconnect between your values and mine.  

    If greater cultural context = hospitals, then this makes sense.  But it doesn’t, and so this equation falters badly.

      0 likes
  • December 6 2009 at 1:45 AM
    Guest writes:

    I agree with much of what

    I agree with much of what you have stated strangelittleloops(huh?) and I appreceate your point of view. I think science proves just how insightful and amazing TCM really is. I for one would have liked more biomedical training in the MS program and spend lots of my “free” time reading western and eastern medical views. I do not know enough about the FPD to have much of an opinion yet. I do question the motives and who is behind pushing for it. I think that we need to slow down and step back to see the whole picture of TCM in America and look for the real needs and how we want to be in the future as a profession and not think a new title will substantially change anything.
    Aloha,
    Jenna

      0 likes
  • December 6 2009 at 1:47 AM
    Guest writes:

    oops on the

    oops on the spelling..appreciate.

      0 likes
  • December 6 2009 at 2:28 AM
    LarryG writes:

    cool Jenna

    so are you stating your opposition to ACAOM?  They should hear your voice.

      0 likes
  • December 6 2009 at 10:04 AM
    annmongeau writes:

    To strangelittleloops

    I wrote that post because of the comments I read on the TCM yahoo group.  Some of your collegues do believe they will be able to talk WM equally with MDs.  I disagree and wrote from my experience.

      0 likes
  • December 6 2009 at 12:05 PM
    tessmcginn writes:

    I’m not sure I get this entire thread

    and it is IMHO derailing from the subject of why I am personally (and I hope you are too) opposed to FPD.  I am opposed to it because:

    1. Those supporting it are creating the training with no details as to how this is going to support students after they graduate.  Where are all these knowledgeable students going to go?  To start your own business, you don’t need the knowledge a FPD can teach.  

    2. If you have been in practice awhile you can see that knowing lots of Western science can be useful, but now for deciding where to put what needles and for how long to retail them.  That takes lots of practice and schools are not designed to allow that.  Nor have I noticed that is where their interests lie.  

    3.  If anyone was to tell me that our profession needed more training in herbs I would agree.  But studying more in herbology should be a choice not mandatory.  Let the acupuncturists get out there ASAP and start learning their work on real patients. 

     4. FPD is only a way to keep everyone from talking about the real problems in our profession.  Once again, those numbers!  Way more graduates of schools than acupuncturists practicing.  Relatively few Americans even know we are out there to help them.  Why do naysayers of us “whining, do-gooder” CANers seem to wax on about our interplay with our culture at large but fail to address the reasons for it?  BECAUSE THEY HATE TALKING ABOUT numbers!  What? You have an affinity for science but hate math?  

     

     

      0 likes
  • December 6 2009 at 2:53 PM
    Guest writes:

    Of course

    If that is how you feel than I’m glad you are calling “bullshit”. I personally call bullshit on a lot of things in life, but I try to do it after becoming informed as much as possible (sans hysteria) and I try not to do so in a way that fractures my own community.

    My point above is not necessarily that the FPD is perfect and we all need to blindly support it. Its a complex issue that I am still personally trying to educate myself from all angles to see what all of this means. I’m not going to just come to this website and based on one set of dogma make my decision. I have to source from all angles in order to make an informed decision.

    My response to this blog is more to point out the inflated assumptions about what it means to have a relationship with the biomedical community. We can all make assumptions about what it means to “be on equal footing.” I don’t see a critique of what that actually means here. I only see a lot of assuming language that is being used to fortify an argument against the FPD.

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  • December 6 2009 at 3:05 PM
    Guest writes:

    differing values

    good question.

    “The greater cultural context” I admit is quite a vague thing to say. So, I am a little guilty of being a bit vague there. I didn’t go into detail because my response was more about pointing out the assumptions held by the original blog post. Honestly, I’m still working out in my own mind what the greater cultural context means (to me). But yes, part of it is definitely, absolutely about bringing acupuncture to hospitals.

    I’m not so sure our values diverge as much as you assume. Its easy to think so, being that I am, at this point in time, a supporter of an FPD.  I say “this point in time” because as I go through all of this information I find it to be a process of understanding and I leave myself open to being flexible with that process.

    That said, I’m not sure I understand your last sentence about predicting grief and hubris.

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  • December 6 2009 at 4:28 PM
    LarryG writes:

    SLL

    re: “The greater cultural context”

    different economic classes have different cultures.

    different cultures have different values. 

    and the people within these cultures use medicine and see healers differently.

    That, in brief, is a good reason to oppose the FPD, as it is tailored to fit AOM into one culture; the professional middle class culture, hospitals, et al. 

    If the FPD wasn’t designed to be the entry-level, it wouldn’t be so opposed.  By replacing the masters as entry-level, whether it takes 3,5 or 10 years, we do a disservice to our entire culture at the behest of attempting to solidify aom in one sub-culture. 

    the conversation won’t stop when the fpd is defeated and tailoring AOM to hospitals will continue to be discussed.  integrating AOM more efficiently into hospitals or alligning it into the perception of “doctor” will continue to happen, and it should.  but if consensus is declared by ACAOM, it happens by disregarding the evidence that CAN presents to the AOM community that AOM can thrive outside of the western medical construct.  we don’t want it all our way.  but it appears that the primary supporters of the fpd that have worked hard to get the profession to the same point we were at 2 years ago want it all their way.

    aom is big enough for all class cultures.  the fpd isn’t.

    so in weighing evidence, I think you have to consider that an evolving conversation about AOM in the context of race, class and culture continues if there is no consensus and either stops or is radically limited if there is consensus.

    we have a rare and unique chance to make AOM more inclusive, more open, more flexible, more adaptable, more utilized rather than let it be so limited and defined by so few.  we can all participate in creating what is approprite today for knowledge and techniques that have survived thousands of years.  we can potentially help a lot of people. and as we expose more people to AOM, they and us can dialogue/create culture that is appropriate for us all.  we just have to open our minds a little and be patient.  it’s pretty cool actually. 

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  • December 6 2009 at 5:46 PM
    Guest writes:

    thanks Jenna

    thanks Jenna. I think its wise to step back and investigate something from multiple angles (the FPD), and its good to consider motives, dogma, etc.. from all sources that stand firm on any issue.  I share the same sense.

    I personally love science and do not see the need to create a binary mindset around science/math vs. TCM/AOM, etc… I actually think it is harmful to have such an attitude.

    The ancient Chinese were adept at human anatomy/physiology and were possibly the first to discover blood circulation in the 2nd Century (Europe published this discovery in 1628 by William Harvey), the first to use thyroid replacement using dessicated pig/sheep thyroid in the 7th Century, had highly sophisticated sublimation techniques in endocrinology, developed methods of immunology like inoculation against smallpox,  discovered and treated deficiency diseases like Beriberi, and had a sophisticated treatment protocol for Diabetes.

    Was this system of knowledge and technique completely divorced from the use of herbs, acupuncture, meridian theory? I think not. There is no need for us to do the same. Now for those who are going to inevitable jump on this- I don’t mean we should all become MD’s. I am just pointing out some interesting facts and considerations. So when you start in with this idea that our field doesn’t need a background in science, etc… think again.

    Here is one of my references if you are interested:
    “The Genius of China: 3,000 years of Science, Discovery and Invention” by Robert Temple

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  • December 6 2009 at 6:05 PM
    Guest writes:

    OK Larry

    I have to admit that at first I was sure that the FPD was a good idea. However, as I stated before, after my initial reaction I am beginning to soften. The reason I am beginning to soften is because I can understand the points you make above and I agree with you on much of what you said. I suppose I just find some of the dogmatic language used here on CAN to be distasteful and I didn’t want to align myself or my profession with such polarization.

    But not wanting to align myself with such polarization does not mean that I should automatically support the FPD, so there you have it.

    I also personally react when there is such an anti-science, anti-biomedicine attitude being flung about. Its silly and does not serve our professional well to be so dogmatic. When I see people openly admitting that they “laugh”  at the idea of taking physiology or physics, well that is just exposing their own ignorance and bias and it does not represent our position as healers well.

    Nonetheless, I like what you have said. Your right, just b/c an FPD is off the table does not mean the dialogue is over. Also I agree that you also have good points about the cultural context and perhaps I should be concerned that an FPD would limit accessibility. I’m not saying you have converted me but what you are saying resonates much more than some of the more “dogmatic” approaches at work here on CAN.

      0 likes
  • December 6 2009 at 6:10 PM
    bottley writes:

    This is important, Larry

    I think you’ve just nailed down the points that have been nagging at me most as I’m trying to order my own thoughts on this. If our institutions were doing as good a job at preparing and supporting practitioners for the ENTIRE spectrum of need for our medicine instead of focusing their efforts so exclusively on inclusion the biomedical and insurance systems, much of this debate would be unnecessary. You’re right, the integrative conversation, including the doctoral issues, will go on, and it absolutely should. The issue of what Chinese medicine has to offer hospitals and the existing medical system is an entirely worthwhile one, but it’s also immensely complex, and an entry level that simply offers a quantitative increase, in other words, the same thing we already have, just more of it, doesn’t accomplish much that will really facilitate that. What I think I and many others of us are arguing for, is opening up the discussion to a wider set of possibilities, a discussion that widens and diversifies the entry pathway rather than narrowing it, which I feel the FPD would do. If the discussion was instead, on how to create a COMPLETE spectrum of professional opportunity, from simple, affordable neighborhood clinics right up through doctors and hospitals, and how to make it possible for more students and practitioners to flourish everywhere along that spectrum, I suspect most if not all of the anger from places like CAN and groups like it would morph pretty quickly into a hell of a lot of support for the job everyone in Chinese medicine should be doing together, which is using the immense power of this medicine to make a difference in the general healthcare mess. 

      0 likes
  • December 6 2009 at 6:13 PM
    Guest writes:

    but what does that even

    but what does that even mean?? to believe you can’t talk *equally* with an MD?

    That is my point.

    What does that even mean?? to *get* respect from an MD?

    Why is it assumed that we (those who support an FPD or considering it) strive to *get* their respect and that if we don’t we are then a smaller version of ourselves? annmongeau, I respect your experience and what you are saying, but I become reactionary when I see someone making sweeping judgments about another based on invalid assumptions and then to use those assumptions to fortify an argument. Like I said, you make some very good points, its just the position you assume about other LAc’s is not correct or fair.

      0 likes
  • December 6 2009 at 6:27 PM
    Nora writes:

    Hey SLL!  (are you a knitter?)

    I just want to say that I don’t think any of my colleagues here are actually anti-science or anti-biomedicine (correct me if I’m wrong, y’all).  Being skeptical of the way biomedicine is delivered in this country (or NOT delivered) is not the same as being anti-biomedicine—in fact, you could easily say the opposite, because who cares about folks having access to something that is worthless? 

    Instead, contrary to our contrarian image, most of us are just very PRO-acupuncture and pro-accessibility, and have
    understandable qualms about anything that we believe would lead to
    decreased access to acupuncture.  I think my colleagues are all very thoughtful people (and a very motley bunch, too); sometimes some of us might come across as
    a little quick on the draw, but that’s because we’ve been thinking and
    talking about these issues amongst ourselves for a long time (not to
    mention being deeply influenced by our practices).

    Also, as you say, you don’t have to agree with everything everyone on CAN says to agree with us on this one issue.  For non-Community Acupuncturist, anti-FPD perspectives, check out these recent guest blog posts:

    http://www.communityacupuncturenetwork.org/blog/comments-regarding-first-professional-doctorate-frank-ervolino

    http://www.communityacupuncturenetwork.org/blog/educational-dilemma-minority-view

    http://www.communityacupuncturenetwork.org/blog/balancing-top-down-bottom-matthew-bauer

    http://www.communityacupuncturenetwork.org/blog/posted-permission-letter-colleague-opposing-fpd

    http://www.communityacupuncturenetwork.org/blog/chiropractors-perspective-fpd

      0 likes
  • December 6 2009 at 6:46 PM
    Guest writes:

    excellent point.

    If the discussion was instead, on how to create a COMPLETE spectrum of professional opportunity, from simple, affordable neighborhood clinics right up through doctors and hospitals, and how to make it possible for more students and practitioners to flourish everywhere along that spectrum, I suspect most if not all of the anger from places like CAN and groups like it would morph pretty quickly into a hell of a lot of support for the job everyone in Chinese medicine should be doing together, which is using the immense power of this medicine to make a difference in the general healthcare mess.

      0 likes
  • December 6 2009 at 10:15 PM
    Guest writes:

    Im not a knitter,

    but I can see why you would ask!

    I’m just a fan of DH’s work:

    “In the end, we self-perceiving, self-inventing, locked-in mirages are little miracles of self-reference.”

    — Douglas Hofstadter, I Am a Strange Loop p.363

    thanks for the blog links, I’ll check them out.

    I think I know what you mean about being skeptical of biomedicine. There are many reasons to be, too many reasons to go into here. I also understand why some of your colleagues become reactionary. But I think we sometimes need to disentangle these feelings of dissatisfaction and skepticism from the good that biomedicine does and not view the entire profession with disdain, OR we should be able to disentangle enough to not attribute the entire field of science to some other-worldly plane that has nothing to do with AOM.
    thanks again.

      0 likes
  • December 6 2009 at 11:53 PM
    bottley writes:

    SLL

    Your points are well-taken. I think one of the reasons CAN folks sound so strident about that issue is the one that ultimately underlies most of the “health care crisis”. It’s the one that seems the hardest to talk about, and that’s the historical and current relationship between medicine and commerce. I think that’s what all this is REALLY about and it gets talked about extensively here.  In many circles, that’s a very nasty, taboo subject, and those that don’t belong to the Church Of The Holy Marketplace appear to believers as rude, inconvenient heretics, to be sure.  I can only speak certainly for myself, but I suspect I have a lot of company when I say that I doubt anyone on our side of the debate doubts the power, necessity and appropriateness of biomedicine. My objection is what happens to the medicine when it starts being more about how it’s paid for than who got helped, and when the system gets so bound up in economics that it controls its practitioners by making it more and more exclusive and expensive to participate. The FPD feels to me like it’s pointing down that particular road. 

      0 likes
  • December 7 2009 at 1:33 AM
    bmiller writes:

    I love science!

    Science is great. 

    In my post I was not laughing at science or the need for it, but rather the fact that in acu school we are asked to complete far more tangential science classes than one needs to be a good acupuncturist.

    I personally cannot figure out how the physics, organic chem, bio chem, and micro classes that I took will help me in the clinic. I do, however, recognize that there were other WM classes that were important.  

    I was laughing at is how ridiculous it is that we spend so much time and money not focusing on practicing acupuncture and or herbs in school. 

    There just has to be a better way to do this so that practitioners are adequately trained, not in debt up to their eyeballs, and patients get access.

    Best,

    Blythe 

      0 likes
  • December 10 2009 at 11:01 PM
    Nityamo writes:

    Don’t shoot the messenger

    I dont read what Ann said as insecure. I have worked with many, many MDs (heck, even some of my best friends are MDs!). I agree with Ann that they do not and will not ever accept an LAc, DOM, or whatever degree, as equal to their training in Western Medicine, just as we will never accept medical acupuncture as equivalent to our training. Why should they? Why should we?

    I would like it if you used your comment to present your arguments and not to tear apart the psychology of the poster. I didnt see any arguments, just a personality attack…. Why?

      Nityamo

      0 likes

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