Tuesday, September 18, 2012
Legislative Update: Governor Signs SB 628 (Yee)
Last week, Governor Jerry Brown signed SB 628 (Yee), a bill regulating doctoral titles used by California licensed acupuncturists. CSOMA has received a number of inquiries regarding this new law. This email addresses some of the major questions we have received.
In this update…
What does SB 628 do?
Very little. SB 628 introduces nothing new. It simply takes decades-old California Acupuncture Board (CAB) regulation (16 CCR 1399.456: Use of the Title “Doctor”) and places this language—word for word—into statute. When it goes into effect on January 1, 2013, the new law will change nothing except that it will take away the CAB’s power to make changes to regulations governing doctoral titling. Any future changes in this area will require approval by the California legislature rather than the CAB.
Both the existing regulation and the new law prohibit acupuncturists from using the title ‘doctor’ or the abbreviation ‘Dr.’ in connection with an acupuncture practice unless s/he holds a doctoral title by license (e.g., MD) or unless s/he possesses an earned doctorate from an ‘accredited, approved, or authorized educational institution’ in acupuncture, oriental medicine, a biological science, or a field related to the practice of acupuncture. Both go on to prohibit the use of the title ‘doctor’ without further indicating the license or degree that authorizes its use.
Why was SB 628 enacted?
The purpose of moving CAB regulation into statute is unclear. This change does nothing more than eliminate the California Acupuncture Board’s authority to regulate in this area.
The bill’s author (Senator Leland Yee) asserts that this legislation will help improve the quality of acupuncture in California. The few supporters of the bill have claimed that the bill would raise the status of acupuncture in California and encourage advanced studies in the field.
Given that existing regulation is identical to the language of this bill and given that existing regulation has been in effect for more than 20 years, CSOMA did not and does not see meaningful or substantial positive impacts from this new law. Likewise, we do not anticipate substantial negative impacts.
Did CSOMA take a position on SB 628?
CSOMA took a ‘neutral’ position with respect to SB 628. Given negligible change to the status quo introduced by SB 628, we elected to focus our advocacy resources on higher priorities, including the successful defeat of SB 1488 (Yee), a bill that would have established a ‘California Traditional Chinese Medicine Traumatology Council’ without establishing adequate training standards.
Does this law impact my ability to use the title ‘doctor’ if its use isn’t connected with my practice?
No. SB 628 only restricts how a California licensed acupuncturist may use the title of ‘doctor’ in connection with the practice of acupuncture. It does not not impact how doctoral titles are used by licensed acupuncturists when this use is not connected with acupuncture practice in California.
What licenses entitle me to use the title of ‘doctor’?
Both current regulation and SB 628 are silent with respect to which other licenses would authorize the use of a doctoral title. Acupuncturists licensed in other medical disciplines should check with the relevant California licensing board(s) for information regarding authorization to use doctoral titles under these licenses.
For those California licensed acupuncturists who hold a doctoral title by license issued in another state (e.g., Doctor of Oriental Medicine in New Mexico, Doctor of Acupuncture in Rhode Island, medical doctor in any other state), we urge extreme caution. While SB 628 does not explicitly state that licenses authorizing the use of the title ‘doctor’ must be issued by California, it is reasonable to conclude that this is implied by the law.
What degrees entitle me to use the title of ‘doctor’?
To authorize the use of the title ‘doctor,’ both current regulation and SB 628 state that degrees must be:
- An ‘earned doctoral degree;’
- From an ‘accredited, approved, or authorized educational institution;’
- In acupuncture, oriental medicine, a biological science, or is otherwise related to the authorized practice of an acupuncturist.
To meet criteria #2 above, an educational institution must either be:
- Accredited by an accrediting agency recognized by the United States Department of Education; or
- Approved or authorized to operate by California’s Bureau for Private Postsecondary Education (BPPE).
All DAOM post-graduate degree programs are accredited by Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM), a United States Department of Education recognized accrediting agency. Therefore, all of these degrees qualify.
CSOMA believes that the second standard (approval by BPPE) is inadequate. It is our view that all education in the field should be held to the significantly more rigorous United States Department of Education standards. This may be an issue for our field to address in the future. However, given the longstanding nature of existing regulation, CSOMA did not raise objections to SB 628.
Do doctoral degrees earned abroad entitle me to use the title ‘doctor’?
Both current regulation and SB 628 restrict the use of the title ‘doctor’ to those who have an ‘earned doctoral degree’ from an ‘accredited, approved, or authorized educational institution.’ Neither the United States Department of Education nor the California Bureau of Private Postsecondary Education (BPPE) regulate international educational institutions. Therefore, California licensed acupuncturists who have earned doctoral degrees abroad may not use this as the basis for using the title ‘doctor’ or the abbreviation ‘Dr.’ in conjunction with the practice of acupuncture.
It would appear that individuals with internationally earned doctorates in the field may still list these doctoral credentials after their name (e.g., Jane Doe, LAc, PhD) as long as these credentials are not false, misleading, or deceptive.
What is the proper way to use post-nominal letters?
This isn’t directly related to SB 628, but we’ve occasionally received questions regarding the proper use of post-nominal letters (i.e., letters placed after the name of a person to indicate that the individual holds a position, educational degree, accreditation, office, or honor). So we’ll take the opportunity to provide some guidance on this front.
Here are some guidelines generally used in the United States:
- Post-nominal letters are typically listed in the following order:
- Academic Degrees—listed lowest to highest (e.g., MBA, DAOM);
- Honorary degrees;
- Professional licenses (e.g, LAc)—listed from highest to lowest importance (as you determine) or alphabetically;
- Professional certifications;
- Professional associations and affiliations.
- List only the highest degree earned in a particular discipline (e.g., ‘Jane Doe, DAOM, LAc’; not ‘Jane Doe, MSTCM, DAOM, LAc’).
- If a doctoral post-nominal is used (e.g., DAOM), don’t use ‘Dr.’ prior to your name; this is redundant. It’s ‘Jane Doe, DAOM, LAc,’ not ‘Dr. Jane Doe, DAOM, LAc.’
- Generally, no more than three post-nominals are listed unless you have a compelling reason to list more.
Additionally, current regulation, SB 628, and California Attorney General Opinion No. 87–103 all clearly indicate that a California licensed acupuncturist may not use the title ‘doctor’ or the abbreviation ‘Dr.’ without also indicating the type of license or degree that authorizes this use. For example, ‘Dr. Jane Doe’ and ‘Dr. Jane Doe, LAc’ are not permissible as they do not also indicate the doctoral license or degree. ‘Dr. Jane Doe, DAOM, LAc’ or ‘Dr. Jane Doe, MD, LAc’ are permitted (assuming, of course, that you hold a DAOM degree or MD license respectively); however, as we noted above, the prefix of ‘Dr.’ is not typically used concurrently with doctoral post-nominal letters (e.g., DAOM or MD).
California Attorney General Opinion No. 87–103 makes clear that using the initials ‘OMD’ or the title ‘Oriental Medical Doctor’ without further information that removes the implication that the individual is a physician or surgeon. For example, ‘Jane Doe, OMD’ is not permissible; ‘Jane Doe, OMD, LAc’ is permissible assuming that the OMD degree was granted by an accredited or approved institution as explained above.
Finally, all of the restrictions on the use of doctoral titles apply equally to written and spoken communications in connection with the practice of acupuncture. The law does not make a distintion between the two.
As always, we welcome and appreciate feedback. You may send comments to email@example.com or contact CSOMA toll-free at 800.477.4564.
CSOMA. Your Partner in Practice.