It’s been too long. September brought a rush of obligations. And my post of X things (X to be replaced with a number when the list was completed) wrong with ACAOM’s gainful employment letter made it to 25 things by the time I got to the bottom of page 2 (of 7).

The gist of ACAOM’s letter — It’s not our fault. The cost of the education and the inability of many of our graduates to pay off their loans in a timely fashion has nothing to do with ACAOM, the schools, or CCAOM. It’s the fault of the system and the poor choices of our grads.

If you believe the schools and professional organizations should spend less time denying responsibility and more time taking responsibility, let them know by signing this petition.

My top 7 issues with the letter:

• The authors absolve the schools of responsibility for the success or failure of their graduates. Where is their evidence that “the primary determinant for success in earnings is dependent upon the students who make their own personal choices….”  And doesn’t an effective education include helping students make choices that lead to success?
• The organizations claim to represent the entire profession without justification.
• With the exception of CCAOM, the participating organizations are operating far outside their missions. For example, NCCAOM’s job is to provide a means of credentialing practitioners to protect the public. Why are they weighing in on student loans?
• The authors conflate the impact of the proposed gainful employment rules with the impact of student debt on establishing a practice. It is student debt that limits practice choices, not plans that would prevent excessive debt for ineffectual schools.
• While the authors blithely refer to the “realistic” time frame to establish a health care practice, materials provided to prospective acupuncture students are silent on such matters.
• Putting schools in charge of the metrics (like graduation rates) that determine loan availability is a classic fox guarding the hen-house scenario.
• The salary figures reported in the letter are questionable at best and mostly irrelevant. Even if it were true that the median salary of practitioners with 20+ years of experience is $122,500, which is doubtful, an acupuncture education 20+ years ago was far less expensive and shorter. (Perhaps the lack of federally guaranteed student loans had something to do with that?) Graduates who could not establish a successful practice are not around twenty years later. What are grads supposed to do about their loans for the first twenty years of their professional life?

It’s requiring a good deal of self-restraint not to continue with my list, but enumerating the failings of ACAOM’s letter doesn’t create momentum for positive change. A petition signed by some of those 30,000 people the organizations claim to represent might create momentum. It isn’t easy to determine how best to lower costs and increase practitioner support. It will require careful analysis and consultation with experts. But if the powers don’t care enough to ask the questions, we’ll never approach the answers. Sign the petition.

(Before you say it isn’t possible, here is a school that has designed an affordable acupuncture program with a focus on creating successful practitioners.)