What is a DOM?
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What is a DOM?

Recently a colleague posted a response to: What Does DOM Stand For? I wanted to share the same information with my patients here in northern NM. So I am reposting some of the information from Hallomai Healing Arts (Albuquerque). She writes that in the state of NM, Doctors of Oriental Medicine (DOMs) are licensed as Primary Care Providers (PCP) by the New Mexico Board of Occupational & Professional Licensing. DOM is a state designated title, granted based on hours of education and examination. 

Other titles, depending on the state, are Licensed Acupuncturists (LAc/ LicAc), and Oriental Medicine Doctor (OMD). Less commonly seen are Registered Acupuncturists (RAc), Acupuncture Practitioner (AP), (Certified Acupuncturists (CA), Doctor of Acupuncture (DA/DAc), and Traditional Chinese Medical Doctor (TCMD in Canada).  No matter what the letters behind their name, these letters always imply a state issued license and malpractice insurance. 

National Certifications, Masters & Doctorate Degrees, Grand-Fathering
A PhD is the standard level of formal education in China; a Master degree is quickly becoming the standard in the U.S. However, historically in China and elsewhere, the art & science of the medicine has been rigorously passed down from generation to generation through apprenticeships. A practitioner who has completed such apprenticeships may also be grand-fathered into practice in the U.S.

Masters programs are approximately 4 years in duration. The education encompasses approximatley 3,500 hours of training that includes herbal studies and internships in acupuncture clinics as well as various Western medical out-patient, primary care, and residential settings. Depending on the program, the degrees granted are called: Masters Degree in Oriental Medicine (MSOM), Masters of Traditional Oriental Medicine (MTOM), or Masters of Acupuncture & Oriental Medicine (MAOM).  

PhD level practitioners have completed an additional 2 years of study to include research. They qualify for Fellowship from the Acupuncture Society of America (FASA). Inherent to PhD level training in China are clinical rotations in acute care specialties such as critical care, medical surgical, and obstetrics.

The National Certification Commission for Acupuncture & Oriental Medicine (NCCAOM) is the regulatory agency that hosts national certification examinations. NCCAOM certification is quickly becoming a standard requirement for licensure. NCCAOM grants "Diplomat in Oriental Medicine (Dipl. O.M.)" status after passing 4 standardized exams:

1] Acupuncture Point Location
2] Biomedicine
3] Chinese Herbal Prescribing
4] Foundations [Chinese medical theory]

The credentialing requisites for licensure still vary greatly by state. For example California does not require NCCAOM certification, but rather its own very difficult written state board exam. Whereas, New Mexico requires NCCAOM certification AND a practical [hands on] state exam. Licensure in New Mexico requires:

  • Master Degree [or PhD]
  • State Board Exam
  • National Certification [Dipl. O.M. NCCAOM]

Who Else Can Do Acupuncture?
While Acupuncture & Oriental medicine is the expertise of a DOM, DOMs are not the only licensed or unlicensed healthcare providers who can legally perform acupuncture techniques. However, unlike licensed acupuncturists/ Doctor of Oriental Medicine, they have far less education & clinical hours in Eastern Medicine as a whole. They are therefore limited in their scope of practice. Here are examples:

medical acupuncture & dry-needling.
MDs and DOs can be formally trained in Medical Acupuncture- a 300-hour curriculum. Scope of Practice is regulated by the American Board of Medical Acupuncture (DABMA/ ABMA). and the American Academy of Medical Acupuncture (AAMA). Chiropractors and physical therapists may receive formal training in "Dry Needling", This is the treatment of muscle trigger points with acupuncture needles [vs. the traditional injection therapy with hypodermic needles]. Dry-needling certification is granted after a 12 hour, two day training by private entities such as Dry-Needling Institute. Scope of Practice is regulated by states, and the American Physical Therapy Association.

acu-detox specialists.
Unlicensed staff of chemical dependency & harm reduction programs can be trained & certified as Acupuncture Detoxification Specialists (ADS). Under New Mexico law, they can perform the NADA Protocol in recognized state-based programs. They are permitted to insert small needles in only 5 specific ear points, and/or tape acupressure seeds or pellets on the same points in each ear. A DOM must visit/ supervise the program at least once every 6 weeks, and be remotely available to the ADS and patients when not on site. Trainings are provided by private entities such as Public Health Acupuncture of New Mexico. Certification is granted the National Detoxification Association [NADA]. DOMs assist with chemical dependency & harm reduction with or without NADA certification - See about Acu-Detox.

practical & manual therapy acupuncture.
The American Manual Medicine Association (AMMA) offers a Diplomat Certification in Manual Therapy & Acupuncture (D.Ac.), and a Practical Acupuncture Certification (P.Ac). Applicants to the D.Ac. track must have completed an accredited doctoral program in medicine, osteopathy, chiropractic, naturopathy, or a related health care profession. The P.Ac track is for nurses & allied medical professionals who will be working under physician supervision. Both must pass AMMAs Acupuncture National Board Certification Exam  (NBCE). The web-based and in-class acupuncture training is through Blue Heron Academy , who grants an Acupuncture Technician Certification (C.Ac). 

It must be noted that the purported national exams conducted by and subsequent certifications granted by the AMMA and Blue Heron Academy are not recognized by the NCCAOM, the NM Board of Acupuncture & Oriental Medicine, nor the NM Board of Nursing. Even though malpractice insurance is available for their credentials, it is unclear who legally oversees the D.Ac, PAc, and C.Ac practitioners compared to the other professional titles for acupuncturists listed above. What exactly is the Scope of Practice for the D.Ac, PAc, and C.Ac compared to that of the DOM [which is clearly defined].

Scope of Practice
In New Mexico, DOMs provide services that include but are not limited to acupuncture & herbal prescription. This is because New Mexico recognizes DOMs as Primary Care Providers- but not all states do. The Scope of Practice in New Mexico includes the following, which is paraphrased from Title 16, Chapter 2, Part 2: Scope of Practice:

  • Evaluation, management & treatment
  • Diagnostic examination, imaging, laboratory testing & surgical procedures of acupuncture
  • Stimulation of points, areas of the body or substances in the body using qi, needles, heat, cold, infrared & UV light, lasers, pressure, magnetism, electricity, bleeding, suction
  • Physical medicine therapeutic exercises, qi exercises, breathing techniques
  • Dietary & nutritional counseling and the prescription or administration of food, beverages and dietary supplements therapeutically
  • Counseling & education regarding physical, emotional and spiritual balance in lifestyle
  • Prescribing, administering, combining, providing, compounding & dispensing any non-injectable herbal & homeopathic medicines, vitamins, minerals, enzymes, products, natural substances, protomorphogens, glandular & live cell products, amino acids, dietary and nutritional supplements; cosmetics as they are defined in the New Mexico Drug, Device and Cosmetic Act, and nonprescription drugs as they are defined in the Pharmacy Act
  • The prescription or administration of devices, restricted devices and prescription devices as defined in the New Mexico Drug, Device and Cosmetic Act (Section 26-1-1 NMSA 1978) by a doctor of Oriental medicine who meets the requirements of NMAC [ NMAC - Rp, NMAC, 02-15-05; A, 11-28-09]

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