5NP 4 OR Update
plus anniversary confessions
I started writing this newsletter almost exactly two years ago; I posted “Welcome to WCA’s Substack” on June 18th, 2023. Last Wednesday, the governor signed our 5NP legislation (HB 2143A) into law. Oregon has a 5NP law!
So this seems like an opportune moment for some reflection — and some confessions.
For anyone who’s new here (welcome!) in 2022 WCA invested some of its COVID rescue funds into coaching with social impact consultant Camille Trummer, to help us chart a post-pandemic path forward. The goal of the coaching was to make acupuncture accessible to more people by developing strategic partnerships with organizations. As we worked our way through the process, it became clear we needed a newsletter of some kind.
Confession #1: I always planned to use it in support of organizing for a 5NP law. In July 2023, I posted a short interview with Will Miller about our partnership with the NAYA Action Fund. That post was light on details, intentionally so. We didn’t have a big audience at that point and nobody asked any awkward questions like, “Wait, why exactly is WCA partnering with a legislative advocacy organization? You’re up to something, aren’t you?” 1
We were, but on Will’s advice we didn’t say what until January 2024, after we’d secured a sponsor for our 5NP legislation — Representative Rob Nosse, pictured here getting 5NP at the Capitol:
Once we knew that Rep. Nosse was committed to being our legislative champion, I let the 5NP cat out of the bag via a second interview with Will, along with an announcement that the NAYA Action Fund was convening a Coalition for 5NP in Oregon. And then we were off and running, “making good trouble” as Will put it.
At the same time that we were working on a 5NP law for Oregon, so were advocates in Illinois. Unfortunately their bill didn’t advance. According to the Chicago Sun-Times:
The Illinois Society of Acupuncturists, which opposed the bill, said in a statement the training that would have allowed people to perform the five-needle protocol isn’t equivalent to the level of training required of a specialist.
“True health care equity is not achieved by cutting corners or diluting professional qualifications — it is achieved by ensuring that every patient, regardless of background, receives the same high standard of care. Lowering these standards in the name of access benefits no one; rather, it risks further marginalizing the very communities this bill claims to serve,” the group said.
This argument is what community acupuncture is always up against: the idea that creating access = lowering standards. Communities shouldn’t be allowed to have acupuncture on their own terms because it’s not the right kind of acupuncture.
Don’t get me started on how many of the acupuncture profession’s standards are arbitrary and self-serving (spoiler: a lot).2 Something I’ve learned over thirty years of practice as a licensed acupuncturist — this is some deeply esoteric knowledge I’m about to drop but stay with me — acupuncture that people receive is 100% more effective than acupuncture they don’t receive. Shocking but true!
5NP is potentially a huge community resource for healing, but it’s been derailed in many places because of acupuncturists who think it’s the wrong kind of acupuncture.
When we talked about this in class, a first-year POCA Tech student said skeptically, “So these acupuncturists who are so concerned about every patient receiving the same high standard of care — are they also volunteering to treat all the people who could’ve benefited from 5NP? Are they going to do the work themselves?”
(We feel very fortunate and grateful that we avoided this scenario in Oregon, and this is a good time to thank everyone who helped us navigate the dicey parts; you know who you are.)
Confession #2: My not-so-hidden agenda for this newsletter is to show that expensive, exclusive, and high-barrier doesn’t automatically equal better quality — or especially, better organized, safer, and ultimately, more useful. We’re talking about acupuncture here but really you could apply this principle to everything else. One of the hardest parts of being a class straddler is dealing with society’s belief that the way low income people do things is automatically the wrong way — when often it’s a perfectly fine way, not to mention stress-tested, efficient, resilient, and replicable.
Now that Oregon has a 5NP law (I still can’t believe it) what comes next is rule-making. The Oregon Medical Board has to hammer out the practical details of regulating 5NP practitioners, which means convening working groups and writing drafts and opening up public comment periods — all the behind-the-scenes labor that goes into enacting legislation. It’s a lot of work, and it’s even more challenging because the new regulations will apply not only to professionals who already have licenses but (we hope) to an enormously diverse range of laypeople.3
In other words, it’s time to build infrastructure! Confession #3: I love infrastructure. Because systems, structures and processes are what make community resources like 5NP useable and useful. Access to care has to be built one step at a time by actual humans; it doesn’t magically fall from the sky once a bill gets signed. (Though it would be neat if it did.) Recently we had a class about systems with second-year POCA Tech students and I said, if you don’t get anything else out of this program, I hope you get this — that your belief in “inclusion” or “equity” is no use to marginalized people UNLESS you also commit to the unglamorous labor of building and maintaining functional structures, that include actual people. (Bonus points if they’re people you don’t like or agree with.) Marginalized people’s needs aren’t concepts. Your ideals don’t do anybody else any good unless, you know, you do something with them.
Less yelling, more planning; less righteous indignation, more follow through.
I feel incredibly lucky that we get to follow through on our 5NP dreams. Thank you to everyone whose efforts got us here — and to everyone who’s been reading about it for the last two years. We’re excited for the next phase.
It probably helped that the NAYA Family Center was supporting WCA and POCA Tech in so many ways it was hard to keep track of the details, and so even people in our world didn’t notice the bit about “legislative advocacy”. Moral of the story: the right organizational partnerships will take you a long, long way.
Not to mention self-destructive. Can a profession die of snobbery? We’re about to find out!
I’ll keep you posted on the timeline as the process unfolds. In the meantime: huge appreciation to Nicole Krishnaswami and Elizabeth Ross of the Oregon Medical Board for all the heavy lifting to make 5NP real for Oregonians.
Great work Lisa