A Feature or a Bug?

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When a trusted business or organization screws up, it’s good to give them the benefit of the doubt. We all make mistakes.

I have trusted the NCCAOM. They were important to our acceptance as a legitimate profession. In 2014 I encouraged people to support a transition to their exams in California, hopeful that one national standard of entry would further the growth of the profession.

But I’ve noticed a pattern – the NCCAOM makes a big announcement and seems unprepared for the response. They scramble to address the upset, explaining why we don’t understand their good intentions or their difficult position.

I used to think it was a bug. They just weren’t as competent as I’d thought. And Acupuncturists mostly don’t understand their role and are quick to react.

But now I think it’s a feature.

We don’t understand their role because they talk out of both sides of their mouth – they say or do contradictory things depending on their immediate desire.

In the “NCCAOM Questions and Clarifications” document (released in draft format), their response to the reaction to the changes in testing policies, the NCCAOM writes:

“There are some policies where we may ask our stakeholders’ opinions and use that to determine policy.  There are many other policies where this is not appropriate because of the requirements of our accrediting body, fiduciary responsibilities (the fiscal health of NCCAOM), or impacts to public safety need to drive our policy decisions.  NCCAOM is not a membership organization, it is a credentialing organization. Examples of this include: the elimination of the apprenticeship-only route, elimination of the pre-graduation route, and the revisions to the NCCAOM® Code of Ethics and the Grounds for Professional Discipline. These are examples that our policies are driven by our NCCA accreditation standards.”

But the NCCAOM did ask for input on the Code of Ethics and Professional Discipline, and their revised code reflected that input.

And the NCCAOM did step back from some of their announced changes in response to concerns from stakeholders. Clearly they had some flexibility, and could have done this prior to their announcement.

And in 2016 the NCCAOM shared –  “Breaking News! New Membership Organization Announcement!” describing their “Academy of Diplomates.” The Academy Board is a subset of the NCCAOM Board, your NCCAOM recertification fees support this organization, and links on the Academy website take you back to the NCCAOM. No wonder we’re confused.

In “Questions and Clarifications” we read – “It is no secret that the number of students taking the exams, annually, has dropped dramatically over the past decade.” Their upbeat NCCAOM Spring 2018 newsletter doesn’t mention it, nor has it been a topic in their frequent Acupuncture Today articles. Study their annual reports and you can uncover the truth, but that isn’t the news they’ve been sharing.

Fewer people taking the tests means fewer new practitioners. Shouldn’t the profession give scrupulous consideration to any policy or regulatory changes that make it harder to enter the field?

The NCCAOM’s current honesty regarding their financial concerns is appreciated. It also demands that we reconsider their previous denials that money drives their policy positions. Their support of efforts to require the herb exam of all practitioners (UtahNCCAOMletter), and their complicated PDA system, make sense from a financial perspective, not from a safety one.

The NCCAOM denies that their exams shape our education. They say schools should not teach to the test. They also advertise, “It is recommended that ACAOM Approved Schools Faculty members sign up for [the NCCAOM] practice tests to familiarize themselves with the process.”

They dismiss concerns that a new voluntary certificate program could become mandatory. They simultaneously support efforts to make the voluntary herb testing mandatory.

Underneath it all is the refrain, the “NCCAOM’s number one priority and mission is to protect the public.” This is as it should be. But one insurer recently reported receiving 1-3 reports of harm per week, including reports of pneumothorax, burns, and infections. In a profession of, at best, 30,000 practitioners, shared between multiple insurers, that’s alarming. Is there evidence that patients in Maryland or West Virginia, where there is no NCCAOM testing requirement, are more likely to suffer harm?

With great power comes great responsibility. The NCCAOM denies their power and their responsibility, but they are the gatekeeper to the profession. They have us by the short hairs. Their denials aren’t believable.

I’ve given them the benefit of the doubt for years. I’ve explained away their errors as bugs and defended their good intentions. It’s painful to acknowledge that I no longer trust the NCCAOM.

They need to get a lot more honest and a lot more competent quickly, or we need to get serious about finding an alternative.

 

 

 

NCCAOM Updates and Links of Interest

The NCCAOM has responded to community concerns about changes to their testing procedures.

Here is an explanation of why they needed to change to limited testing windows and delays in providing preliminary results, along with a statement that they will delay this change to 2020. They will also work with the schools to set the testing windows to coordinate with graduation dates. Please do read it so you understand why these (temporary) changes will happen.

And here is the FAQ regarding the elimination of the Pre-graduation eligibility route. The date for this change is still September 1, 2018, and the FAQ isn’t quite so transparent. I do understand that the NCCAOM has to treat all applicants the same. Under the current system students of ACAOM-accredited schools can begin testing prior to graduation, while those in apprenticeship or foreign programs can’t. So, that’s not right. But some of the supposed benefits in the NCCAOM FAQ don’t seem all that beneficial. The answer to Q2 doesn’t actually answer Q2. And could they address the problem with less disruption? Allowing all students to sit all but one exam prior to graduation might address some of the problems mentioned by the NCCAOM without leaving new graduates in limbo for quite so long.

Here are some interesting links in no particular order. The issues may not be directly related to the acupuncture profession, but affect the bigger ecosystem.

A Dark Side of Chinese Medicine

Results of VT Medicaid Pilot Project using Acupuncture

The Value of the Doctor-Patient Relationship

For Fun if You are in New York City

Increasing Tuition at For-Profit Schools as GI Benefit Grows

Healthcare for those with Disabilities

Family Physicians on Nurse Practitioner Scope

Occupational Licensing for those with Criminal Records

The Acupuncture Observer’s Odds, Ends, and Action Items

I can’t keep up, so prepare for some less polished posts as I play catch up.

First, housekeeping —

I’ve been using the blog for essays and analysis and using The Acupuncture Observer and Acupuncture Regulation-US Facebook pages to share articles of interest. Follow those pages, and if the FB algorithm cooperates, you’ll get important background and stay on top of current events.

I kind of hate Facebook and may give it up one of these days. Subscribe (if you haven’t already) to The Acupuncture Observer blog by entering your email address in the box in the upper right (under the banner photo) of the home page. Don’t count on Mark Zuckerberg to show you what’s important.

I’m considering a weekly (or so) blog post with links to a selection of the articles I’ve been posting to FB. Good idea?

Regarding The Acupuncture Observer —

I am not a journalist. I am an acupuncturist with experience on the board of state and national associations and the state regulatory agency. I am also a news junkie.

I have a point of view.

That point of view is informed by my experience, research, insider reports, news, transcripts of meetings, etc. I link to supporting information. My opinions are not based on hearsay or one individual’s report.

If I am wrong, let me know. That’s what the comments are for. I moderate to exclude spam and to reduce unnecessary rudeness, not to shut down differences of opinion. Reach out if you’d like to run a guest post.

If the position of you or your organization is already widely known, and especially if you have ready access to Acupuncture Today or widely distributed organizational newsletters, don’t expect equal time here. You already have a forum for your positions.

I’ll issue a correction if you can show me that I’ve got faulty information. But just telling me that I’m wrong or stupid or “clearly don’t understand” isn’t helpful. Show me the evidence.

And, an Action Item —

The NCCAOM has recently announced changes to their testing procedures.

1)      As of this September, people will no longer be able to sit the exams before they graduate.

2)      As of 2019, the exams will only be offered during four 12-day windows. There will be two testing windows for foreign language exams and reinstatement exams.

3)      People will no longer get preliminary results immediately after taking the exams and will need to wait eight weeks to find out whether they passed. That will give people a week, at best, to register for and re-take any exams in the next testing window.

See page 11 –  http://www.nccaom.org/wp-content/uploads/pdf/2018%20NCCAOM%20Spring%20Update%20to%20CCAOM.pdf

Unlike some changes at the NCCAOM, I don’t blame a profit motive. Each change, in and of itself, has a reasonable explanation. But, the sum total of the changes will have a negative impact on the ability of recent graduates to obtain state licenses in a timely manner. Enrollment in ACAOM schools dropped 18% between 2014 and 2018. Meanwhile, the demand for acupuncture is growing. It’s a terrible time to drag out the licensure process.

I hope you will sign the petition. (The petition language incorrectly refers to regulatory changes. The changes are to NCCAOM policy and procedures.)

 

 

 

We have met the Enemy

It’s not paranoia if they are really out to get you.

Our siege mentality is understandable. Doc Hay was charged with practicing medicine without a license in the early 1900’s, as was Miriam Lee in 1974. In some places we’re still seeking legal recognition of our right to practice. It’s not unusual to read that acupuncture is quackery.

So it’s not terribly surprising when multiple participants in an official government meeting announce that your practice is a danger to the public and that the NCCAOM Acupuncture credential is insufficient. It’s not the first time we’ve heard that it would be better for the public if we were excluded.

But it’s different when the people saying these things are Acupuncturists.

It’s shocking. And upsetting. And bad for the profession.

We complain about PT’s, Medical Acupuncturists, insurance companies and even the perceived disrespect of some of our clients. But those groups aren’t building coalitions to restrict our ability to practice, or to put hurdles in the path of new practitioners. I can imagine the outrage and the calls to action if they did.

Instead, it’s Acupuncturists who are on the record (warning audio autoplay) slandering colleagues and attempting to slow growth of the profession.

Our safety record and our well-established and generally respected educational and credentialing systems don’t seem to matter. Nor are these Acupuncturists concerned about our small numbers or student debt.

Why is this happening? One school that is concerned about student debt, accessibility, and the growth of the profession, asked ACAOM and NCCAOM to reconsider the hourly requirements for acupuncture education and sitting the credentialing exams. There was no move to lower standards (read more here) or change competencies, only to use the same hourly requirements that served our teachers and most experienced practitioners so well.

ACAOM hasn’t responded to the proposal, and NCCAOM did not respond favorably (NCCAOM Response Ltr to POCA Board 11-9-17 Final with signatures.doc). But members of Utah’s Acupuncture Advisory Board and the Utah Association of Acupuncture and Oriental Medicine were so upset by POCA Tech’s request that they launched a preemptive strike, moving to require the NCCAOM herb credential of all practitioners, whether or not they want to use herbs.

Listen, and ask yourself – how does this help our future?

By the way –

The participants’ claim that this is a clarification of existing law is “alternative fact.” The evidence shows that the Utah action is in direct response to the POCA Tech proposal, and the representative of the Department of Professional Licensing makes clear that existing law would not support this action.

In a prior meeting a board member insisted that there is no need to require specific education or curriculum for practitioners who use injection therapy, since acupuncturists know their limits. The same board member argues here that all practitioners need to obtain the herb credential. (The board member performs injection therapy.)

The exemption of those already licensed works to undermine opposition to changes like this. Don’t be fooled – increasing debt for the next generation of practitioners isn’t good for our future, even if it doesn’t impact your ability to practice.

The Advisory Board and the Utah Association, with the help of the NCCAOM, promoted the Board’s proposed changes. The letter (UtahNCCAOMletter) they distributed is inaccurate. For example, a growing number of states are not requiring the herbal exam of all practitioners, and acupuncture and Chinese Medicine have not always been inextricably linked.

A letter written by a professional association, signed by the Chair of the Advisory Board, and distributed and supported by the NCCAOM (which would benefit financially from the change) raises significant ethical and good governance concerns.

The NCCAOM’s message in the February meeting – that they defer to the will of the profession – is a questionable position for a credentialing agency. It also differs from their position in cases where the will of the profession was for changes not in NCCAOM’s interests, such as a state removing the requirement to maintain active Diplomate status.

There’s good news – the Utah Advisory Board can’t add a requirement for the herbal credential via regulation.

There’s bad news – the parties involved seem eager to pursue legislation to make this change.

There’s terrible news – the enemy is us. It isn’t the PT’s, MD’s, or insurance companies undermining Acupuncturists. It’s Acupuncturists.

 

Firefighting

More than 42,000 Americans died from opioid overdoses in 2016. In 2009 at least 23.5 million people over the age of 12 needed treatment for illicit drug or alcohol use in the US. That number is growing dramatically.

People are dying.

LAcs are rightfully enthusiastic about the use of acupuncture to treat the physical and emotional pain that can lead to the use of and dependence on addictive medications and drugs. We have been proud of the history of auricular acupuncture helping those who struggle with addiction.

The development of a profession of Licensed Acupuncturists and the spread of acupuncture detox specialists happened comfortably, side-by-side, for a long while. Lincoln Recovery in the Bronx was treating addicts with acupuncture in 1974. In 1975 (More History ) the Traditional Acupuncture Institute was founded in Maryland. The AAAOM was incorporated in 1983, NADA in 1985. In many states, auricular acupuncture programs predated the regulation of acupuncture. Their safety and effectiveness was used promote acupuncture and lobby for Licensure.

In 2005 South Carolina (currently 123 LAcs, 658 deaths in 2016 related to prescription opioids and heroin) passed a licensure law with a dark side. Although 53 Acupuncture Detox Specialists (ADSes) had been working without incident in South Carolina, language was included that required an LAc be on site to supervise ADSes. With zero LAcs at the time the law passed, no ADS could continue to treat. (The force behind the legislation was Acupuncturist and then-president of the AAAOM, Martin Herbkersman, whose brother was and is SC state Representative Bill Herbkersman. Rep. Herbkersman also shut down a 2007 bill that would have removed the direct supervision requirement.)

Programs to provide the NADA protocol to addicts have been limited by the supervision requirement.

People are dying.

Unfortunately, South Carolina is not a fluke. The only voices against New Hampshire HB 575, allowing for the certification of acupuncture detox specialists, were the voices of LAcs. Luckily for New Hampshire (127 LAcs, almost 400 opioid related deaths in 2015, over 2000 opioid-related ED visits), the bill passed.

Connecticut (323 LAcs, 539 overdose deaths in the first six months of 2017) did pass a law expanding use of ADSes, but comments in response to the legislation from LAcs included gems like, “acupuncture should be left to the experts, the licensed acupuncturists” and ADSes “have absolutely no idea what it truly entails to safely provide acupuncture to others whether it be one needle or many.”

People are dying.

Remember, at least 42,000 opioid deaths in 2016. The number of Acupuncturists in the US? About 32,000 at best. Dealing with the epidemic is expensive, funding is limited.

It’s a crisis.

  • If you believe ADSes require in-person supervision, become a supervisor.
  • If you believe only LAcs should provide the NADA protocol, commit to weekly shifts at recovery centers, jails, and other programs, and take responsibility for daily staffing of those programs. Remember, funding will be minimal or nonexistent, and, unreliable.
  • If you believe that everyone deserves the benefits of full body treatment, commit to provide them to everyone – even if they can’t pay, don’t have reliable transportation, and aren’t as tidy as your typical clientele.
  • If you believe ADSes should work only within treatment programs available to those in active addiction, make sure your services are accessible to those struggling to maintain their recovery, whatever their circumstances.

Remember, some of the people most needing treatment won’t have insurance, housing, financial resources, steady employment, or reliable transportation. Where and how will you provide the services you think they should have?

If you don’t want to supervise, don’t want to treat everyone who walks through your door regardless of ability to pay, and don’t want to take regular shifts at treatment facilities, then, please, get out of the way of the people who do. Better yet, support them.

People are dying.

I’ve joined NADA, I’m making plans to receive training, and I’ll keep supporting efforts to increase access to NADA-trained providers in all states.

People are dying.

 

This post is in honor of Dr. Michael O. Smith. May his memory be for a blessing.

Fourth Night – Service

Join your state acupuncture association.

At least once in your professional life, serve on the Board of that association, or, serve on the Board of another professional group, or serve on a committee that serves the profession, or serve in a regulatory position.

If you support other groups, like AWB, SAR, POCA, join them too. But not instead.

Join your state association even if you are thinking “but they haven’t done anything that I agree with” or “they don’t do anything at all” or “they are a bunch of a-holes who actively work against my interests” or, “I already support these other organizations that actually do the stuff I care about.”

Trust me, when I get a newsletter telling me that a top priority for my state association is continuing the fight against dry needling, I struggle to write that membership check. (Because the fight has sucked up our resources and poisoned relations with potential allies and there is no chance we’ll win.)

Why give your hard-earned and too often insufficient money to a group that you believe uses it poorly?

  1. Membership organizations are designed to represent the needs and desires of their membership. To think “I’ll join when they stop doing stupid stuff I hate” is asking them to put the preferences of non-members over members, and that’s unreasonable.
  2. Health care is regulated by the states, and the state association has some degree of power (it varies from state to state) over regulations, legislation, and appointments. It’s good to have a say in how they’ll use that power.
  3. The policies of our best hope for a productive, consensus-building, national organization meant to serve all LAcs, the ASA, are determined by a Council, the membership of which is determined by state associations.
  4. There aren’t that many of us. Even if state associations have 25% of their state’s practitioners as members (optimistic – though maybe our lower percentage is related to misperceptions in how many LAcs practice in the state) that’s still a small number. It’s hard to do much if your organization is supported by and represents fifty people.

You should serve on a Board at least once because –

  1. The experience of: working to give people what they want, balancing the demands of those who want very different things, explaining that there is no shortage of good ideas just resources, explaining (again) why the association can’t provide a health insurance plan, giving people what they’ve asked for only to find out they weren’t really going to take advantage of it (you all said you wanted inexpensive monthly CEU classes, but only two of you came) – is educational. It builds compassion and understanding for those who serve.
  2. It will teach you a lot about regulation, legislation, and how some of what people insist we could do if we just FOUGHT, is not actually doable, even when everyone involved fights their hardest.
  3. Numbers again. A fifty person organization, with a five person board, and three committees of three people means about a third of the members have to be serving at any given time.
  4. People usually become willing to make the sacrifice of serving when they get worked up about something. They feel strongly about a particular issue. It’s good to have balance so one strong leader doesn’t shut out other voices.

Now, for my friends who are serving –

  1. Thank You!
  2. Working for consensus is good. Compromise is good. Listen to the concerns of all of your colleagues and don’t automatically respond with the party line. Be thoughtful.
  3. We’d have an easier time getting people to serve if Board members didn’t end up burdened with tons of administrative work. $$ for political action is important, but let’s not neglect the benefits of $ for organizational support.
  4. Criticism is not the same as negativity. Some positions and actions are deserving of criticism. If we don’t dismiss it, we can learn.

 

And, for all of us — let’s not take our differences personally.

 

(It’s not dark yet. I made it.)

 

(Note to self, 8 posts in 8 days requires advance planning. Not a good spur of the moment project.)

 

 

Third Night – Lowering Standards!?

In recent conversations with colleagues I’ve heard a few exclaim “we won’t agree to lower our standards!” and “we aren’t going to go backwards on our education!”

I haven’t heard anyone suggesting that we lower our standards or go backwards, so I was baffled.

Only momentarily, though, because then I remembered -The Acupuncture Revisions Proposal from the POCA Tech BOD to “revise acupuncture education and testing standards so as to benefit current and future (1) acupuncture students, (2) acupuncture schools, (3) acupuncturists, and (4) the general public.”

They make clear that their proposed standards are based around students meeting all of the competencies required for ACAOM accreditation and preparing graduates to be safe and effective practitioners. (The proposal is concise, well-written, and worth reading. Please do.)

Unfortunately, “high standards” in this profession has come to mean number of hours spent in school. So any change in the number of hours is interpreted as a lowering of standards.

I understand how it happened. When we’ve fought for acceptance, we’ve stressed our hours of training to establish our worth. When clients mention that they got acupuncture from their Chiropractor, we talk about how much time we spent in acupuncture school compared to the D.C.’s short courses. Hours of education has been a battle cry in the dry needling fight. (Which has been mostly unpersuasive since the PT’s 1) deal in competencies, and 2) we use different rules when we count our hours and we count theirs.)

Actually, a standard is “a conspicuous object (such as a banner) formerly carried at the top of a pole and used to mark a rallying point especially in battle.” (Merriam-Webster).

So, hours has become our standard. But it’s such a meaningless standard. I’m sure I’m not the only person who’s been to three-day CEU classes that have been a complete waste of time while a one-hour class contains a transformative nugget. I’ve spoken to people who have taught at some acupuncture schools and the picture they paint is not of hour after hour of quality programming.

We’ve got a workforce that needs to grow. And levels of educational debt that are an impediment to professional success. Affording graduate school and repaying loans isn’t going to get easier.

Read the Acupuncture Revisions Proposal with an open mind.

Our banner should be more meaningful than a number.

 

 

Eight mini-Posts for Eight Nights! First Night – Acupuncturists, Weigh In!

The NCCAOM is looking for feedback on a possible Safe Compounding and Dispensing certificate program. I don’t work with herbs so I’m not considered a stakeholder, but please reply if you are eligible. My questions/concerns —

  1. Will the certificate be available to anyone or just those with an NCCAOM herbal credential? Practitioners often delegate herbal preparation to office staff, so staff might benefit the most from the training. Additionally, some excellent and well-trained practitioners aren’t able to sit the NCCAOM herbal exam due to the nature of their herbal education. Could they still obtain this certificate?
  2. Will this certificate result in restrictions on the practices of those without it? The NCCAOM has previously developed credentials promoted as optional, which have, in short order, become requirements.

There are many areas of practice in where some of us could use more knowledge and training. It’s nice to have a way to show that you’ve got some special training or skills. At the same time, we’ve got enough battles with other professions and within the profession, and too often new credentials lead to new fault lines and new tensions.

Share your thoughts with the NCCAOM if you’re a stakeholder. Let’s help them serve our needs and understand our concerns.

 

 

 

Proposal regarding Acupuncture Education

The POCA Tech Board of Directors has been studying what it takes to become an LAc and wondering whether there isn’t a better way. POCA Tech has been approved by ACAOM as a candidate for accreditation, and has graduates who are NCCAOM-credentialed, state-licensed and working in the field. The POCA Tech BOD is in a good position to know what works. Here’s what they propose –

Acupuncture Revisions Proposal

I’ve been around long enough to expect the proposal will be met with some outrage. We’ve been insisting that it is the hours of education we have that set us apart. And that almost 2000 hours of training only scratches the surface of what there is to know about Acupuncture and Asian Medicine.

I’ve also been around long enough to know that 1305 hours of training is enough to produce competent providers. That there are countless CEU programs and additional degree programs to help us deepen our knowledge. And that there is no clear evidence that our more extensive training leads to better outcomes.

People want acupuncture. We need more practitioners to meet the demand. And 100K in debt helps no one. I think the POCA Tech proposal makes a lot of sense. What do you think?

 

 

Happy AOM Day??

“Acupuncture is a safe and cost-effective treatment that could benefit so many. If only the medical establishment could see the benefits of what we do.”

That was our mantra decades ago.

So one might think, now that Acupuncture has become accepted and of increasing interest to the establishment, we’d be happy, thriving, and confident.

But that isn’t the prevailing feeling. We love our work and most of us couldn’t imagine doing anything else. And yet AOM Day 2017 finds us fearful and disheartened.

Many of us carry significant debt and are not earning enough to pay it down in a timely fashion. Many of us are limited in where and how we practice due to varying state rules. The hoped for benefits from insurance reimbursement came with significant administrative burden and limits on what will be covered. Increasingly acupuncture is being provided by non-acupuncturists. Meanwhile, the profession isn’t growing. Based on figures from Acupuncture Today, there are fewer LAcs now (24,612) than there were in November 2013 (24,707).

So it is not surprising that we aren’t hopeful. The public and the medical establishment see the value of acupuncture, but we aren’t thriving.

There are things we control that could change our trajectory.

Those of us who completed acupuncture training prior to 1990 (some of our most admired mentors and colleagues) probably got about 1000 hours of formal schooling. If you graduated in 2000 you likely had about 1725 hours of schooling, and if you completed your training after 2011 your program was at least 1905 hours.

You can see, here, how the Virginia regulations have changed over the years. The hourly requirements did not change in response to concerns about practitioner safety or skill, but to keep the regulations compatible with the ACAOM and NCCAOM requirements.

In 1988 tuition at The Traditional Acupuncture Institute (now MUIH) was $11,000 (about $23,000 in today’s dollars). When I started in 1992 it was about $18,540, ($32,616 in today’s dollars). By 2003 tuition had increased to $32,865 ($43,722 in 2017 dollars). And, if I wanted to begin at MUIH today, the program would take almost four years to complete with tuition of $75,924. For a Masters in Oriental Medicine, necessary to practice in Florida, California, and Nevada, I’d pay $99,604.

A student loan of $40,000 at 6.8% interest can be paid off in 10 years at $460/month – considered manageable with an annual salary of about 50K. A $100,000 loan will take over $1150/month and you’d need to make almost 140K/year to manage that.

So it’s not surprising that the profession isn’t growing and that acupuncturists are worried.

Sure, the NCCAOM can embark on a major public education campaign touting our training and credentials.(Well, touting their credential, actually). That’s fine. But with the downward pressure on health care spending in this country, and the impact of debt considerations on professional training, it’s going to take some damn fine PR to make a difference. (Big Pharma & Health Products spent about 245 million on lobbying in 2016.)

A far more direct way to help the profession grow, help future graduates make a living, and make Acupuncturists available to those who want acupuncture would be to address our training. If those who graduated in 1989 were safe with a 1000 hour $18,000 education, why do current students need at least 1905 hours and $75,000? Can we simplify the path and reduce the cost of becoming an Acupuncturist? (Yes, we can!)

If people want acupuncture they will find a way to get it. If we’re not there to provide it, someone else will be. We do have the power to change this, and it won’t take 245 million. In honor of AOM Day 2017, let’s agree that more Acupuncturists and less debt would be a very good thing.