Tag Archives: debt

Dry Needling, Herbs, and Scope — How to Regulate a Profession

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A regulatory Board is contacted.  Your licensees are doing X, that isn’t (or, is that?) in your scope.

Ask a PT Board about Dry Needling and the answer usually goes something like this — We trust our licensees. Many learn this technique and it helps their clients. We find room in our regulation to include this in our scope.  We have a few concerns and suggest that those who want to utilize this technique have some additional training and take additional precautions. Our existing system for addressing unsafe practice is sufficient to address risk to the public.

Ask an Acupuncture Board or organization about herbs and the answer usually goes like this. We are being threatened again!  We’d better legislate, and fast! Help! Thanks NCCAOM and schools. We are so grateful for your efforts to ensure that any acupuncturist who wants to utilize this dangerous aspect of our medicine add your $20,000 education and your formal $800.00 seal of approval to their already extensive education and credentials. In fact, in the name of raising standards we should require that from all LAcs. It might prevent some of our most qualified practitioners from practice, but, hey, it is a step toward getting the respect we deserve.

Is something wrong with this picture?

It’s a radical idea, but how about we respect ourselves. Let’s recognize the safety of our medicine and the depth of our education.  Let’s trust our colleagues’ professional judgement and open doors rather than close them and let’s stop deferring to those who profit from our love of this medicine.

For additional reading, check out an example.  In this case, I agree with Dr. Morris when he wrote,

To avoid conflicts of interest, no individual who stands to profit from seminars should determine competencies and educational standards, nor should they testify in legislature on behalf of the common good.

(Of course, he was talking about the PT’s when he wrote it, so maybe in this case he doesn’t agree with himself.)

You have until Monday, 9/30, to comment on the NCCAOM’s “proposals.” Does the current CEU arrangement put the public at risk? Are the states incapable of effective regulation?

One more thing — during the great FPD debate, many expressed concern that once the degree was available the NCCAOM could, by fiat, require it for entry level practice. We were assured that would be impossible. Informed by history, it seems very possible indeed.

So You Want to be an LAc

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Dear A,

I don’t know whether I am a leader. I do know that there is a big difference between being a leader and being a cheerleader. I care too much about my profession and the medicine of acupuncture to blindly cheer it on. I speak up because I care.

I assumed when you asked me about a career in acupuncture that you wanted the honest feedback of one who has seen it from the inside. The field does have challenges: the education is expensive; the schools do not do an equally good job of teaching the medicine or preparing graduates for business success; there is no reliable way to know which programs are doing a good job; rules and regulations vary so that your education may only provide you limited opportunity; you will likely begin practice as a self-employed individual starting a business from the ground up, and so on. I did not say it was the most expensive or most difficult profession, and, as I did say, I love acupuncture and am happy to be an acupuncturist. It was not my intention to “actively discourage” you, but to help you enter with eyes wide open.

My concerns about Medicare are varied, but overwhelmed acupuncturists is not one of them.  In the 2010 AA letter you found I was pointing out that the cost savings of Medicare inclusion being promoted by the profession could not be realized through the efforts of LAc’s alone. There were not enough acupuncturists, especially LAc’s interested in participating in Medicare, and those individuals were not geographically distributed such that they could create the savings being touted.  For much of the profession the thought of non-LAcs doing acupuncture is Anathema and interfering with the ability of other health care professionals to use our techniques continues to be a major focus of political involvement and spending. It is reasonable to point out to the profession that the Medicare push may undermine efforts to maintain a monopoly of the medicine. Your accusation that I am personally driven by a fear of competition could not be further from the truth. I have repeatedly urged my colleagues to drop their monopolistic mind-set and focus on self-improvement and promotion.

I am sorry that my response upset you.

An article of interest?

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An article about the experience of acupuncture school grads could read a lot like this article in today’s New York Times’ Business section.  Many acupuncture students (and student wannabees) are ignorant (or even worse, misinformed) about the business realities they’ll face upon graduation, and the schools, ACAOM, and the AAAOM have not made changing that a priority.  I suppose they have no incentive to give an accurate picture of professional opportunities or the lack thereof because they depend on a constant stream of students to pay the bills.

I took special notice of the section on the under-served areas of the country, since this is something we find in acupuncture too.  The reference to the loan forgiveness programs was also informative.  I know some of the leaders in our field have pointed to inclusion in these programs as a potential cure for some of our problems, but I see there is still quite a bit to learn about them.

The article does not consider whether the increase in health insurance for pets is contributing to the declining salaries.  A topic for further consideration, perhaps.

The article reminds me of the topic of unintended consequences.  I remember when eligiblility for federal student loans was celebrated as a great step forward for the profession.  Now, I can’t help but think the main consequence has been to enable the schools to charge more, and students to unthinkingly take on more debt.  I’m excited for the arrival of POCA tech — a school with a goal of making acupuncture education affordable.  Not only does the school promise to be a great addition to the profession’s education options, but we can hope that competition for student dollars exerts some downward pressure on the other acupuncture schools’ tuition bills.