At the time of the murder of George Floyd, members of his immediate family expressed amazement at the influence of his life through the manner of his death. They would not likely have guessed then that the social combustion over systemic racism and related colonial suppression would a month later prompt a community-wide consensus to remove a term that has been central to defining a core field in the integrative health and medicine space. An intense, open, and well-managed exchange has commenced among leaders of the profession of acupuncture and medicine from Eastern Asia to remove from their label a term of a racist and colonial origin: “Oriental.” Executives of the field’s accredited colleges are the core participants in the exchange, and the input has grown from there. Significant agreement exists to remove the term. Replacement may prove more problematic.
It’s a big deal for the field. The “O-word” is emblazoned in the name of a majority of its schools, state associations, and in principal national agencies. Witness this triumvirate: the Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM), National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM), and the Council of Colleges of Acupuncture and Orientation Medicine (CCAOM). It’s embedded in many state licensing statutes. Opening up laws can always be risky, as shared below.
I was invited in by a convenor of this dialogue, educator David Solin Lee, EdD, the vice president for academic affairs at Alhambra University. I met Lee nearly two decades ago when he was CEO of what is still the Emperor’s College of Traditional Oriental Medicine in Los Angeles. We were working on a project funded by Lucy Gonda to provide acupuncture and other integrative services to the underserved through community clinics. Lee has held multiple leadership roles since including helping create multiple Doctor of Acupuncture and Oriental Medicine programs at serving on over 20 accreditation site visits, many for schools with the “o-word” in their name. Not once, Lee shares with the group, has he raised the issue of the name. Lee is showing a servant leader approach to managing the change effort, creating space for all voices to be heard, and then advancing step-wise via consensus.
A very few participants expressed little problem with the “o-word”. Yet It quickly became clear that that overwhelming response to Lee’s initiative is that it is long overdue. The continuing use is felt by most as an abiding embarrassment. The field has in fact lagged behind the federal government. In 2016, US president Barack Obama signed a law sponsored by Congresswoman Grace Meng (D-NY) removing the term from federal documents. The replaced it with “Asian American.” The same law removed references to “negro” and replaced them with “African American”.
Some legislative challenges of the removal were detailed by LiMing Tseng, LAc, a leader of the American Society of Acupuncturists and a past leader of the state association in Vermont. Tseng shared some of the dimensions and losses that came from cleansing its laws and regulations of the “o-word”.
I would like to offer the case of our Vermont acupuncture statutes. A few years ago, we opened up our state laws so that we can “simply” clean up our practice act to remove the word Oriental. We knew that opening our scope could open a can of worms, but we thought that perhaps this was a “simple” fix (after President Obama signed H.R.4238), it would slide through relatively easily. Our volunteers of the Vermont Acu Assoc (VTAA) Legislative Committee along with our paid lobbyist, at a significant cost, spent about 1.5 yrs on this project. We still had to pay 2 yrs for the lobbyists. In the process of opening up our practice act to remove the word Oriental, we lost the ability to have Acu Detox Specialists in Vermont. Additionally, we lost our herbal regulation. We no longer have to take the NCCAOM herbal exam to practice herbal medicine in VT. The VTAA did not request either one of these, we just wanted to clean up the language. The VT legislature decided that they didn’t want to regulate so much. There were a lot of passionate pleas to keep AcuDetox practitioners. Because our national organizations are written into our state scopes of practice, at some point, changing the names of the national organizations will require all 47 states to have to update their scopes. Perhaps we will gain some things grounds on scope, or we could lose some ground.
In short, anything can happen. And as was shown in the state of Washington, a new name may not stick. After renaming itself the Washington East Asian Medicine Association, additional pressure and information later led to a second change to Washington Acupuncture and Eastern Medicine Association. Here is a summary of the logic:
Once we realized that we couldn’t keep the name we went through many iterations of possibilities: Asian included Russia; Eastern seemed too broad; Acupuncture Medicine was a very close second, but many people still wanted to include the heritage; Chinese medicine was too exclusive; using the term Traditional in any way wasn’t favored because it might make the medicine seem too ‘folksy’.
The participant then explained: “Our medicine is systems-based and grew from the Eastern philosophies of balance and interdependence. That was the one consistent thread throughout different aspects of the profession and education. We included Acupuncture as well because that is our title in Federal Legislation and our professional BLS code.” The change was further explained: ”
The Chinese community associated the term “East Asian” with the Japanese occupation, anti-Chinese propaganda, and atrocities. “Eastern Asian,” though it seems very close, didn’t trigger the same response. The change was spearheaded when a Chinese practitioner was head of WEAMA.
The dialogue produced a long list of possible names. Among these:
- Acupuncture Medicine (“Our profession has an opportunity to ‘own’ acupuncture if we use the term ‘Acupuncture Medicine’.”)
- Asian Medicine (US government term)
- Doctor of Acupuncture and Eastern Medicine
- Acupuncture and East Asian Medicine
- Acupuncture and Integrative Medicine
- Acupuncture and Other Medicines (to keep to the AOM acronym)
- Acupuncture and Eastern Medicine (Washington State)
- Sino-Medicine Doctor
- Acupuncture and the Medicine Systems of Eastern Asia
One relevant decision was made nearly a decade ago with the naming of the American Society of Acupuncturists, the top national professional organization in the field. A participant shared that the founders determined that “acupuncturist” was the “the best solution for avoiding problematic terms, and because it was consistent with the [Bureau of Labor Statistics] designation. The full BLS title is “Acupuncturists and Healthcare Diagnosing or Treating Practitioners.”
Just a reminder – we do already have a Bureau of Labor Statistics designation for the professional group. This was more than 10 years in the making (longer really, considering what is needed to prove the validity of the group as a group). It’s not to say this title couldn’t be changed. We would have to do some serious research in determining how to make the change if desired. It would not be an easy fix, as it’s the federal government and would demand they change systems they essentially just established for us in 2019.
A strong constituency clearly likes the “acupuncture” focus. It is an alignment with BLS and with the public’s main handle. Some urged “Acupuncture Medicine” as a way of suggesting the profession’s contributions are beyond using needles.
The considerations are many. Passions are high. Choices are loaded. One participant spoke for others: “Not to use ‘Asian’ or ‘East Asian’ is an act of erasure.” Another: “At this point, I desperately want to remove the current language that we have.”
In the midst of the activity, Tamsin Lee, DAOM, Dipl. OM, LA.c, AEMP the founder of an organization of acupuncturists called Influential Point posted a petition at MoveOn “to NCCAOM, ACAOM, and all East Asian Medicine academic institutions.” The call: “Remove the racist term ‘oriental’ from the acupuncture profession.” At the time of this writing, 1997 of 2000 targeted signatures had been gathered.
Influential Point’s work is “dedicated to wiping out racism and whitewashing of acupuncture” is featured here. Lee’s stridency defines one end of the dialogue. It stems from a view that racism permeates the acupuncture field far more deeply than removal of the “o-word” alone can address:
I hope everyone is on the same page in realizing that removing the o-word is just the beginning, and most likely, the simplest thing we will do. American acupuncture was built on the foundation of systemic racism and this is embedded in every aspect of our medical education and training. There is a long list of much more challenging issues we have to overcome.
Action on removal was underway amidst the dialogue. Just prior to Lee’s first posting, the faculty council of the New England School of Acupuncture voted unanimously to remove the term “oriental” from its programs, courses and degree designations.” Presidents of multiple other colleges announced that they were on board the change effort. The California State Oriental Medical Association (CSOMA) announced that its boar voted unanimously to change the corporation’s name to remove the word “Oriental.” The organization’s president Nell Smircina, DAOM, LAc, noted the context:
This is a critical time … Particularly in times of change we all need to say, ‘What can I personally do?’ This was something tangible we could do.
The association had previously renamed its journal from the California Journal of Oriental Medicine (CJOM) to the Journal of Acupuncture and Integrative Medicine (JAIM). The release noted that CSOMA anticipates a 3-6 month timeline for the completion of the change.
Lee has managed the dialogue, thus far, as a series of phases. The first, aptly titled “Burn the Boat,” led to a consensus agreement to drop the “o-word”. One group is exploring the depth of penetration of the term in state laws and regulations. Another is examining historic precedents, and pros and cons of the suggested new names.
U Toronto whole systems medicine specialist and scholar Nadine Ijaz, PhD summarized some affirmative points to consider in the naming: include “acupuncture” as it is recognizable, yet have more than just the word, to keep it from being reduced to needles; ensure the many non-Chinese strands of the medicine are not excluded; and find a term that is palatable and easily understandable. The whole systems expert suggested “Acupuncture and the Medicine Systems of Eastern Asia (AMSEA)”.
While the phrase is cumbersome, I like the accent on “medicine systems” in Ijaz’s formulation. It’s an antidote to the limitation the nation’s licensed acupuncture professionals have sometimes faced in the integration process. The biomedical industry tends to strip these entire systems down to drug form and re-shaping the training of its practitioners into needling technicians.
For years in my own reporting and chronicling, I have sought to buck the reduction by not writing “acupuncturists” but instead using the broader term “acupuncture and Oriental medicine professionals.” Here’s to the adverse consequences of good intentions. In a post to the group Lee convened, Ijaz spoke pointedly of how many more, like me, would need education on the abuse felt by many on hearing that phrase:
As this project advances, this group will surely continue to encounter many good and kind people who remain unaware of, or are not yet sensitive to, how offensive (etc.) it is to continue use of the o-word as a professional descriptor today. This is of course painful and harmful – much like ‘all lives matter’ is so painful and harmful – even when no infliction of pain or harm is intended.
While some of us are learning what not to say, the group convened by Lee is faced with the more challenging task of what to say. Can a field that has never had the uniting professional brand of an “MD” or a “DC” or “ND” use this moment to agree on a shared handle? Time will tell. The steps and commitments already take are in the right direction.
As a prominent Eastern text, the I-Ching, frequently recommends: “It furthers one to cross the great water.”