How we Grow – The Acupuncture Profession in 2015

One Physician per 371 non-institutionalized civilians was the US average in 2012.

One Acupuncturist per 20,000 non-institutionalized civilians was the US average in 2014.

NCCAOM’s 2014 Annual Report is an important read for anyone who cares about Acupuncture in the US. From it we learn:

  • Applications for certifications dropped from 1744 in 2013 to 1494 in 2014.
  • The number of new certifications dropped from 1144 in 2013 to 972 in 2014.
  • 532 of those new certifications were in Oriental Medicine. Another 16 were for Chinese Herbology (likely existing LAcs choosing or being required to add the Herb certification).

I don’t know how many practitioners are leaving the profession, but many of my peers who were licensed 20+ years ago are stepping back from active practice.

Several current initiatives, including HR 3849 and state-level efforts to mandate insurance coverage of acupuncture would increase demand for acupuncture. (There are 49,435,610 Medicare beneficiaries in the US and 5.5 million Gulf War Vets.) If fully trained Acupuncturists aren’t able to meet the demand, who will provide those services?

At this rate, how long will it take to grow the profession to even one Acupuncturist per 2000 people?

Shouldn’t we focus on that?

I’m baffled. We’ve sued, signed petitions, and marched in the street, all to try to stop the “greatest threat to our profession” – other professions wanting to use the acupuncture needle.

But there’s been silence, or even approval, when Florida (with one DOM for every 17,760 people) changed their regulations in 2014 to require all 4 NCCAOM exams for licensure. Ditto in NJ where new practitioners will need the NCCAOM herb exam to use herbs in their practice. (How many citizens had been harmed by use of herbs by practitioners without the herbal credential? Was regulation needed?) In Nevada (approximately 1 Acupuncturist for every 47,000 citizens) the Board of Oriental Medicine is moving to require a DAOM of all licensees. Meanwhile, many insurance plans are limiting their provider pool to those with active NCCAOM certification, even in states that don’t require that credential. (After all, the vision of the NCCAOM is that “Acupuncture and Oriental medicine provided by NCCAOM credentialed practitioners [emphasis mine] will be integral to healthcare….”)

If we want the public to obtain services from well-trained Acupuncturists we need to make sure providers are available. One thousand new practitioners a year and growing self-inflicted restrictions on where and how we can practice aren’t going to do it.

The greatest threat to our future is an Acupuncture workforce insufficient to meet demand or effectively advocate for ourselves. Allowing or supporting credential creep, educational bloat, and practice restrictions are sowing the seeds of our demise.

Can we please focus on growing our profession?

 

Demographic Information From:

Acupuncture Today Density Map

Physician Data

Population Data

Medicare Data

Veteran Data

Copyright —

© 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.

10 thoughts on “How we Grow – The Acupuncture Profession in 2015

  1. Elaine, I wonder what the NCCAOM stats are saying? Does this mean that school enrollment is down? Does this mean that some practitioners have let their licenses lapse or both?

    It would be interesting to see what the numbers are. I suppose one could look at state licensure data: Date of license origin (when first licensed), is the license active, has it not been renewed, has it been placed on inactive status? A tally of all current state licenses vs. not renewed and inactive status might give an interesting picture on the state of this trade, as we all know that organizational membership is not reflective of the number of practitioners. The data could then be parsed by each license renewal year to get annual/biannual running totals to see if there has been actual growth. This can also be compared with NCCAOM new diplomate status applications annually. Big undertaking, but certainly may provide a meaningful analysis.

    • Sorry for double post; I realize that CA does not use the NCCAOM Dipl status, so perhaps the licensure information would suffice. I wonder if the NCCAOM new Diplomate status applications would be indicative of acupuncture program enrollment.

    • JD — I really wish I had the resources, or that some group that did have the resources was willing, to do more parsing of the data. The best information to look at overall licensure would be, of all things, the chart that shows up in every Acupuncture Today. I’m not sure of their methodology. For instance, I know of many practitioners who have licenses in multiple states, but only practice in one. Does AT correct for that? (Because of the ever-changing licensure requirements my advice always is once you have a license never give it up.) I don’t see much growth in the AT numbers from year to year and I’d guess that those numbers are over-counting the number of folks who are seeing more than a handful of clients a week. (I know folks who are basically retired but keep an active license for those rare occasions when they want to treat.)

      I’d hope that ACAOM and CCAOM would be tracking overall enrollment, but I haven’t found any of that data. There are states (CA, NV, WV, MD, probably others) that don’t require passing of the NCCAOM exam, so we can’t rely only on the NCCAOM stats. But I bet the number of folks sitting the exams represent at least 90% of folks hoping to enter the profession.

      • Hi Elaine:
        I put questions regarding the number of practitioners in the US to Bobby Crownfield of MPA Media, the publisher of Acupuncture Today. Acupuncture Today (AT) back in August of 2014.

        http://www.mpamedia.com/aboutus/staff_production.php

        My first query was:

        Hi

        I am trying to piece together the actual number of acupuncturists in the US and it is difficult. Different sources give different numbers and it seems very difficult to get sets of numbers that are not at wild variance with each other. I would just like to ask how your numbers were generated and how were they verified. I have used the NCCAOM database, and various reports generated by them including JTA 2014 and an NCCAOM map that presumably represents numbers that was copyrighted in 2014 (attached). I have also started entering state licensing databases and generating numbers that way. The problem with this of course is that many practitioners hold licenses in multiple states so I am not sure how one goes about removing duplicates. In any event an explanation of how your numbers were generated and verified would be most helpful.

        Regards,
        Joseph Ashley Wiper

        She answered:

        Hi:
        “Our list our generated from multiple sources, mainly the state licensing board list and our verified by active license numbers. WE also verify all addresses by running a quarterly NCOA (National Change of Address) and a daily ACS (Address Correction Service”

        This left the question of duplicate licenses unanswered so I wrote:

        Thank you so much for your explanation. One question I have not been able to resolve from this answer is whether or not there is any effort to remove duplicates from the list. By ‘duplicates’ I mean practitioners licensed in multiple states. I, for example, am licensed in 3 states so would I be counted in the total for each of those states or is there some way that you purge these duplications from the totals? Any insight you have into this would be very helpful. The NCOA database would be helpful for establishing the actual address of a practitioner but, of course, many practitioners reside in one state and practice in one or more others. Many thanks.

        Ms. Crownfield’s reply was:

        Sorry,

        “If we see that the Doctor has a license # for multiple states for the same profession, we only account for 1 state (usually the one he lives in or is closet to according to the address we have on file.”

        Since I do no subscribe to the services mentioned (they are enhanced services which require the payment of fees) in the initial response I am not in a position to verify this claim. I also discovered that not every state makes it easy to verify the number of licensed practitioners in their databases. The project you propose (which is a good one) would be very time consuming and I am not sure that it would even be possible since, currently, lack of transparency seems to be the rule we must all live with.

        Regards,

        Joseph Ashley Wiper

        • Thanks for the research! It’s safe to say that the AT figures at least give us some idea of the “order of magnitude” for the profession. If we combine it with the NCCAOM’s job task analysis which showed large numbers of practitioners working less than full time, I’m comfortable concluding that we don’t have anywhere close to the number of professionals that would be needed to serve the nation’s population of Veterans and Medicare beneficiaries!

    • Hannah — Go to the Home page of the blog – to the right side of the top post you will see a box for your email address and then a box that says “sign me up”. Put in your email address, click “sign me up” and then reply to email you get verifying your subscription. (It’s free.) That should do it. Sorry that the system isn’t set up to allow me to do that directly. Thanks for your interest!

  2. What was not covered was the current wave of practitioners who see no value in NCCAOM certification (including me who used to be an NCCAOM poster boy). The NCCAOM is generally viewed as a necessary bureaucratic entity that siphons off money to ensure it’s continued existence. This view is shared by even some NCCAOM staff who say “we know but it’s a job.”. The largest migration away from the NCCAOM is occurring in its home state of Florida. Since Christina Herlihy’s passing there has been little talk from the NCCAOM about supporting the ability of the organization’s diplomates to practice the profession. Simple things like advertising the difference between a diplomate and a certified practitioner easily come to mind. These issues were important to Ms. Herlihy but she left us too soon.

    • Frank — Actually the NCCAOM is doing more touting of their credentials. But that comes at a price to the profession as a whole. For instance, their efforts to have insurance companies require the NCCAOM credential for becoming an in-network provider. That may force practitioners to continue being part of the “club.” – But it doesn’t lead to good feelings — and it puts those who have let their credentials lapse in a bind.

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