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Standard Bearers: Certain People with Certain Personalities Once the standard was set, Kaminoff figured the work was done. But to his consternation, it was not. Kaminoff lays out his perspective: "The idea of a Yoga organization taking on the approval of teachers or certification programs made me nervous. In reality, the Yoga Alliance only processes information. It's based on trust. If a teacher or school lies on their application, there's very little the Alliance can do to catch it. Since it's all based on trust and voluntary compliance anyway, once the standards were established and publicized, why did we need a group of people to administer them? If a student or an employer has questions about a teacher's credentials, those questions should be answered in the context of a relationship with that teacher - not with a group like the Alliance." [Note: Officially, YA does not "certify" but "register." But leaders acknowledge significant confusion on this distinction, which practically feels like certification to most.] Does All Third-Party Intervention Between Doctor and Patient Corrupt Care? "I am not against high standards," clarifies Kaminoff. "Yoga is about relationship - the connection between the student and teacher. "Any third party that inserts itself into that relationship will eventually destroy it. "It doesn't matter if that third party is an insurer, a government agency or a band of well-intentioned Yoga teachers". "Yoga ethics are very clear on this point. In fact, the teaching concerning what we should avoid (Yama) is presented before we are given the teaching concerning what we should pursue (Niyama). Furthermore, the first injunction is Ahimsa, the avoidance of doing harm. In the context of National Standards, what exactly is it that we must avoid harming? The process of teaching yoga. What is the vehicle for the process of teaching yoga? The student-teacher relationship.Kaminoff draws a breath, reflecting on the frequently poor practitioner-patient relationships in conventional medicine: "I think that the typical doctor-patient relationship has not only had the 3rd-party intervention of insurance, but also 4th-party, 5th-party and 6th-party interventions destroying that relationship. These parties are all pulling the M.D. in contradictory directions. The HMO/insurance forces want to contain costs and reduce procedures. Malpractice concerns would make the doctor want to run the extra test, take the extra MRI. It's hard enough to be a good doctor under even the best conditions. How M.D.'s can even function under the present system is a testament to their dedication to their craft. The fact that certain forces in the Yoga community want to buy into that system is a testament to their ignorance of what it's like to work inside of it. As my friend Tom Myers has said: 'Buying into mainstream healthcare delivery is like handcuffing yourself to the railing of the Titanic.'" Kaminoff continues: "Government gives an illusion to consumers. Governmental standards give a false security. The patient sees the paper and thinks it is meaningful." Kaminoff views the Yoga Alliance standards as already promoting a false security in the Yoga world: "Because a person has a certification to teach doesn't mean anything about their actual qualifications. Promoting that idea is a disservice to the consumer. Try to remember that all the doctors who malpractice are deeply credentialed and licensed. We don't need more framed paper hanging on the wall. We need more honest and open relationships between consumers and providers." What Role then, for a Professional Organization? If a professional organization is not to be caught up in the business of requiring certain educational standards and in promoting licensing, insurance inclusion and expanded scope of practice - typical health professional association activities - what then are its functions? Kaminoff, with his laissez faire (he calls it"objectivist") perspective - ticks off the agenda:
Kaminoff believes that this "free market approach would actually lead the various schools and training programs into a natural and healthy competition to create maximum standards." He feels that the ad hoc committee went "terribly wrong by setting a menu for minimum standards." One of the unfortunate results, in his mind, was "cookbook, minimum-level training programs, and hour-grubbing students treating their precious education as if they were filling up books of Green Stamps." Comment: Kaminoff was introduced to me by John Kepner, IAYT executive director, as a useful interview for capturing the strong current of antagonism among some in Yoga toward profession-wide standards, licensing, and insurance participation. I credit the openness of John and Veronica Zador, RYT-500, IAYT president. Zador, an internationally known Yoga teacher and therapist, is not only president of IAYT but is vice president of the Yoga Alliance and head of the Alliance's Standards Committee.
These issues are dynamic for all professions. The patriarchy, paternalism and vertical, top-down orientations of conventional medicine (and more than a few CAM-IM practitioners) are all caulked and hammered together with certifications, accreditations, qualifications, regulations, credentialing and licensing which are all, of course, without fail, are developed solely to foster the public interest and to protect consumers. Sarcasm is merited here, is it not? One would assume that the consumer was steady on the altar for all this regulatory and self-regulatory action. Yet two earlier articles in this "Future of Yoga Therapy" series on the role of 3rd-party payment in the development of the chiropractic and naturopathic medical professions shows how much the consumer-patient can be lost. The irony - and here Kaminoff's perspectives strike a resonant chord - is that here we are, a half-century into this wild explosion of organized and bureaucratized medicine and what are we doing? We are struggling to put our minds and actions around how to provide care in a way that is "patient-centered." Let's hear from you on this!
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_____________________for inclusion in a future Your Comments article. Links to additional articles in the IAYT Future of Yoga Therapy series: Naturopathic Insurance Leaders on 3rd Party Payment, the CPT, Villani's Views, and CAM-IM Maturation (10/08/06) (Another Kind of) Integration in Georgia: Yoga, Mindfulness, TCM and Functional Medicine at Athens Regional Medical Center (09/07/06) Harvard Researcher Sat Bir Khalsa on "Hygiene for the Body-Mind" and Yoga's Emergence (8/4/06) Insurance Coverage and Development of the CAM Professions: Perspective of Triad's Agostino Villani, DC (7/9/06) IAYT Sponsors IBN&R Series on the Future of Yoga Therapy: Part 1 - Context and Current Initiatives (5/19/06)
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