Late March Update

The weekend is winding down and I didn’t make it to my planned “The Biggest Problem Facing the Profession” post.  However, there is lots of news in Acu-World. Here are some items to keep you busy until I get back to the keyboard.

  • Want to support the profession in a positive way? You may have contributed to funds for inter-professional squabbles or federal legislation. That money hasn’t helped us in a lasting or tangible way. Support POCATech and you’ll be supporting an acupuncture school committed to providing an affordable education. How would your practice be different if you didn’t have educational debt? Check it out here! POCATech will help more people get acupuncture from acupuncturists — it is a win/win.
  • ACAOM is considering changes to the post-Graduate Doctoral Program and they want to hear from you.  The survey took me about 15 minutes, most of that for reading. Personally, I support a Doctoral track open to those who have an acupuncture-only education. There is a long history of practitioners choosing one specialty.  The movement in some states to insist on complete OM or Herbal training and credentialing is discriminatory against acupuncturists and expensive! It is important that we all weigh in, whether or not we plan to pursue a doctoral degree. Deadline for response — April 17th.
  • In January NCASI was celebrating a ruling they believed meant PT’s would not be able to do dry needling in Utah. In March, Utah HB 367, legislation which would add dry needling to PT scope of practice, went to the Governor’s desk for a signature. Shouldn’t be a surprise to anyone. Utah has fewer than 100 LAcs and about 4000 PT’s.
  • Likewise, “despite the warning” of AZSOMA, SB 1154, which would add dry needling to PT scope of practice, has passed the Senate and made it through two committees of the House. The votes have not been close.
  • Last, and maybe least, the AAAOM collapse continues.  Acupuncture Today printed part II of their article, now with updates. The AAAOM came out with a response (prior to the latest updates). Given the latest updates it probably isn’t worth the time to go through the AAAOM response. Suffice it to say, it contains plenty of spin and quite a few inaccuracies. Mostly, I continue to note that we’ve heard nothing from the AAAOM about who is currently in charge there. And, no practitioners really seem to care.

That should be enough to keep everyone busy.  Back soon, with “The Biggest Problem Facing the Profession.” (No, it isn’t Dry Needling.)

“Join your Acupuncture Organization!”

We’ve all heard it, along with “we are doing the best we can with the resources we have” and, “if you participate you can help set our direction.” Heck, I’ve said those things.

Yet membership in most organizations is steady or declining. News of trouble in the AAAOM was met with a yawn. Many acupuncturists are active, involved, motivated people in general, so why do so many of our voluntary organizations struggle?

In a Facebook conversation regarding the AAAOM a current board member wrote “…if we were to have had one failure as an organization … it has been our challenges in staying in touch … to keep everyone up to date about what we’re doing, what we’re facing and how we’re being successful. I can see how not hearing from us creates space for concern and allows the possibility to misinterpret truth from reality.” If there has been one failure??

Another board member dismissed the recent resignations as a necessary step in getting “like-minded” folks on the board. Then, as the day follows the night, the conversation pivoted to a plea for unity, so we could get the big things done, like the FPD. (There’s a unifying topic.)

Having served on the board of my state association for years I remember the difficulty of trying to do much with little. Yet my recent offer [early 2014] to teach members about strategic policy planning was quickly dismissed with “no one would come, but if you write something we’ll distribute it.”  And my recent attempts to communicate with board members (whom I consider to be my friends and respected colleagues) about some of the association’s positions were dismissed with “the membership elects the board and the board sets the agenda” and “I know there are differences but I don’t care about the details.”

Is it any surprise that struggling practitioners aren’t convinced that joining and participating in these organizations will produce results?

One membership organization is doing well. As of February 15th POCA had 1569 members, including 242 clinic memberships (which each include one practitioner membership) and an additional 653 practitioner memberships. It isn’t easy to get membership figures for other acupuncture organizations, but I’ll go out on a limb and say that POCA currently has the largest practitioner membership of the national voluntary acupuncture organizations. (POCA’s 895 patient membership isn’t too shabby either.) POCA doesn’t claim or try to be the organization for everyone, but it has one heck of a mission and is clearly doing a few things right.

Here’s a real kick in the gut — did you know that a group of AOM Leaders has been meeting since 2005 to “promote the general interest of the acupuncture profession”? The next meeting will be held in just a few weeks. Look at the list of past attendees. Who is representing your needs and interests to this group?  Who decides on the participants? Has POCA been invited? Have any of the participants investigated why so few practitioners (who invested in the expensive education, sat for the expensive exams, maintain the expensive credentials) join their acupuncture organizations?  It is not because we are a young profession and it is not because we are cats, difficult to herd.

Is the message that the interest of “the profession” doesn’t include the interests of practitioners?

Last week’s poll was a tie, so this post is a mash-up.  There is plenty to explore regarding our acupuncture organizations. For now, it’s time come up with a plan.  How do we get the “leaders” to consider the needs of those they claim to lead? Don’t say by joining groups that don’t seem to care.

The Acupuncture Profession, News and Analysis

Three dedicated AAAOM Board members and AAAOM (super-qualified, knowledgeable, and committed) Executive Director, Denise Graham (my last hope that things could get better) resigned recently.

One board member spoke of an uncomfortable and increasingly controlled board environment, a declining membership (now less than 2% of the profession), and poor relationships with national and state leaders. Another stated that the AAAOM doesn’t have the support, revenue, or credibility to make progress towards legislative goals.

This isn’t the first time AAAOM has been on the ropes. If it hadn’t been for money from the AAC and support from other organizations, I doubt they would have survived this long. Somehow, though, they still manage to control the conversation.

In other news, NCASI, the National Center for Acupuncture Safety and Integrity, has appeared on the scene. NCASI’s list of “10 Facts” should be titled “10 Things We Insist are True and/or Important.”  Dry Needling by PT’s is legal in many states. Review my past posts on dry needling and scope for more background. We take real risks when we files lawsuits like these.

For twenty years, the acupuncture organizations have insisted that our success depends upon —

  • Increasing credentials/educational requirements/scope. It doesn’t matter if the old education, credentials, and scope worked fine. It doesn’t matter if it increases practitioner expense, decreases practitioner flexibility, or prevents some LAcs from utilizing techniques available to any other citizen.
  • Getting someone else to pay for acupuncture. Fight for third-party payment systems even if other professions report they make good medicine more difficult and practice less enjoyable. Ignore the hypocrisy of participating in a system that requires discounting services while also criticizing LAcs who offer low-cost or discounted treatments directly to patients. Insist that practitioners who don’t want to participate won’t be impacted, and turn a blind eye to the fraud that many practitioners engage in to make the $’s work.
  • Demanding a monopoly.  There’s no need to earn your market share by providing the best product — instead establish it through litigation and turf battles. Don’t worry if this requires you to disparage your fellow health providers or contradict your message that the public should be able to choose their providers.

After twenty years many LAcs struggle to stay in business, and most voluntary acupuncture organizations struggle to survive. Got questions about ADA compliance, insurance billing, privacy issues, advertising questions, disciplinary actions? You won’t get answers from the AAAOM and you probably won’t get them from your state organization.

It’s time to change our strategy. We have enough training, clients who seek our services, and other providers who respect the medicine so much they want use it themselves. Yes, we always need be aware of and informed about the regulatory/legislative landscape, but we also need business skills, PR, positive marketing, and an easing of the regulatory burden.  We need a good hard look at the cost of education. We need legal advice and business tools and positive interactions with potential referral sources and colleagues. We don’t need more legal battles, more regulation, more legislation, more degrees that further divide us.

When our organizations provide these things, we’ll have successful organizations, and successful practitioners. (If you don’t believe me, ask POCA.)

 

An article of interest?

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.