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.

 

 

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© Elaine Wolf Komarow and The Acupuncture Observer, 2013-2018. Unauthorized use and/or duplication of this material without express written permission from Elaine Wolf Komarow is prohibited. Excerpts and links are encouraged, provided that full and clear credit is given with specific direction to the original content.

13 thoughts on “Happy AOM Day??

  1. California Acupuncture Board requires 3,000 hours total of licensees:

    “Title 16, Article 3.5 Acupuncture Training Programs
    1399.434. Criteria for Approval of Acupuncture and Oriental Medicine Curriculum (effective 5/24/2017)

    To be approved by the Board, an acupuncture and Oriental medicine educational and training curriculum shall consist of at least 2,050 hours of didactic and laboratory training and at least 950 hours of supervised clinical instruction.”

    • It hasn’t always. And it doesn’t have to be permanent? Do Acupuncturists in CA have a better safety record or better results than practitioners elsewhere?

  2. Thanks for this honesty about the field. How do you feel about the community acupuncture model and the way POCATech is handling these issues (far less expensive to study ($15k), as well as receive treatment)?

    • I think the Community Acupuncture model and the work POCA is doing is brilliant. Direct action at it’s finest. While the majority of the profession was stuck on the idea that the way to help people access acupuncture was to spend years pressuring insurance companies to cover acupuncture (and now spend years more trying to get the insurance companies to reimburse decently) the folks behind POCA figured out a way to just charge less. And when practitioners insisted that their rates were reasonable given educational debt, they decided to do something about the cost of education. It’s an excellent use of Qi, and they are helping lots and lots of people.

  3. We as acupuncturists are working in a reactive medical model vs preventive. I don’t believe the focus needs to be on cutting school costs to prop up the profession. I see 2 areas that need focus. 1. Patient education – people don’t understand what we do. 2. We, as acupuncturists are incredibly lacking when it comes to having a productive business mind-set. When I was in school many students talked about how they were going to move to Africa and treat people for free. Big hearts but no mind for business and that’s the main problem. You can help people if you can’t stay in business and pay your bills.

    • Certainly, both of the things you suggest would be helpful and are things I’ve been advocating for for years. And, it’s not sufficient. Even in places where there has been lots of attention to the differences in training between, say, PT’s doing dry needling and LAcs, people still choose dry needling. Not everyone values the difference in education the way we think they should, and many factors go into who they ultimately decide to receive care from. As for folks who wanted to treat for free in Africa, they are probably pretty satisfied – they can do that. It’s the folks who expected that insurance reimbursement or jobs in hospitals would be the solution to the struggle, or who say in that business class and did the math, 30 hours a week/45 patients……

      Sure, educate the public and the students, but 4 years and 100K in debt and a health care system that needs to be paying out less not more, and the math just doesn’t work. We are not growing. The demand is growing.

  4. It’s going to take a few years for the laser to penetrate the public mind as an effective tool, but by the time it has I suspect that going to acupuncture school will be unnecessary. The laser cuts through all the stuff you are pointing to Elaine – the ever growing hours, the credential creep, the growing costs, the regulations. Learn theory, practice, go to work! It’s going to change the profession. We grumble about PTs and DCs and MDs – wait ’til the laser gets going!

    • Someone is about to read this comment and start drafting new regulations. First, add lasers to LAc scope, then, add hours of training in lasers to the curriculum, then start fights with anyone using lasers…..

  5. Hi Elaine, I did not remember how much it cost us to go to school. Just remember I only needed to borrow $7000. Most of the rest of the money came from the money I saved working 2 jobs for 7 years. I remember thinking I would never finish paying the student loan back. I can’t imagine having to pay back a loan of the magnitude required now.

    I am sorry to read that there are fewer acupuncturists working now. I definitely could not afford to go to school now. I can’t even afford to take the chinese herbs course and then try to take the national exam. Even to register for the national exam is expensive.

    It is surprising to me to read that my profession is having these problems, when I just thought I had bitten off more than I could chew. I opened my 5 room office in 2002 and left in 2017. Over 15 years I spent over $200,000 in rent and expenses. Yes I made a good living, but it was too much money going out for not enough income. And I thought I had a good head for managing. No training was offered at the TAI school in running a business. I did go to the small business administration and attend some classes after I had been in my big office about 4 years. Their courses were more geared to retail sales. I did get help from a retired executive who advised me to stay in the office another 5 years, since I had sunk about $15,000 into it to fix it up for my use. Jack Daniel offered a class one time in running an acupuncture business, it was helpful to a degree. I remember one of the teachers saying that acupuncture was the last medical degree where you graduate, go and hang out your shingle and work up from nothing. With most other professions, the new graduate joins a practice. Not acupuncturists, when we graduated.

    I stayed another 7 years, while the business slowly went down hill. Fewer sub-tenants, and fewer patients. The last 3 years, the landlord lowered the rent to keep me there, because I had found a nice space for less money. Finally I threw in the towel on the big office and moved to a single room in another office. I am not making the money that I was making and I am not paying for any overhead, other than rent. I am happier now, with less money stress. And I am proud of what I accomplished and how many people I have helped.

    I have always enjoyed your blog and the information you have posted. This is the first time I have posted back. I always appreciate your point of view and your ability to highlight things. Thanks for all the work you do.

    • Glad you find the blog helpful. I get distressed when I hear about people who are paying off loans long after they’ve left the profession. Folks definitely start without a clear idea of the challenges they may face.

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