Answer: Less than it used to be.
(Please, sign the petition.)
If you earned an MAc and Dipl. Ac (NCCAOM) twenty years ago, you thought you had it made. You could get a license in almost all states with licensure. The schools and the NCCAOM touted the caliber of the education and credentials. You knew you had plenty to learn about this medicine, but you could practice safely.
In the gainful employment letter ACAOM points to the (supposed) earnings of those long-ago grads to minimize the financial struggles of recent grads.
But in 1995 the NCCAOM added the Herbal exam, and later the OM. Some states now require those additional credentials of all practitioners. ACAOM has increased hourly requirements for school accreditation several times. And the NCCAOM has put additional limits on who can take their exams.
Some of our most esteemed teachers do not meet the current requirements for sitting the exams. Many practitioners are trapped, unable to relocate.
By increasing the range of degrees and credentials available before our “brand” was established and our profession was strong, the alphabets increased division and confusion. No wonder the public can’t figure out how an LAc’s education compares to that of other providers.
And here comes the First Professional Doctorate. With this new degree, my alma mater announces,
“[graduates] will be recognized as doctors, both professionally and publicly, and will have increased credibility and standing.”
If graduates with an FPD have increased credibility and standing, what has happened to the credibility and standing of graduates of Masters programs?
According to ACAOM’s gainful employment letter, licensure requirements just happen, and practice success is a simple matter of practitioner choice.
Really, though, the “alphabets” have played a significant role in the expansion of requirements and credential creep, and most of the schools do little to teach students how to make wise business choices.
If, as ACAOM wrote, the graduates of twenty years ago do so well, why have entry level requirements been increased so much? Why are grads struggling to pay off existing loans encouraged to return to school to maintain their credibility? Will the NCCAOM require an FPD to sit their exams? Will the alphabets encourage states to require it for licensure?
ACAOM/NCCAOM/CCAOM/AAAOM — if you represent us, defend the value of our degrees and credentials. Your “options” too often become a requirements.
Colleagues, did the gainful employment letter represent your views? If not, sign the petition. 129 people have, which means ACAOM etc. can still claim to represent 32,871 of us.
For additional information and analysis about educational costs and value, check out this from The New York Times and two posts from Dr. Phil Garrison
© Elaine Wolf Komarow and The Acupuncture Observer, 2013-2033. 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.
Name: mark seem
Comment: Dear Elaine,
Our Board Chair and former NCCAOM commissioner who overlapped with me in about 1987 shared your BLOG and news on the organizations you mentioned.
I have stepped down recently as founding president of the Tri-State College of Acupuncture (in CT from 1982, moving to NYC in 1994 after 13 years lobbying for a NYS law that allowed for schools and US trained paths to licensure in NYS), half a year before my planned 66th birthday due to deep distress at where the CCAOM and AAAOM and NCCAOM are taking the profession – groups I worked with in an intimate, and often critical manner for 32 years.
While I agree with much of what the other blog replies share, and much if what the CAN has shared for years about the dangers of the First professional Doctorate which they chose to pin on me personally, I wish to point out that simplistic and dualistic interpretations about the plight of these national AOM organizations do much to blur the issues.
The issue is not between for-profit and non-profit colleges. As was pointed out, a non-profit like the NCCAOM can be run like a for-profit with huge benefits to its CEO. And many of the 41 ACAOM accredited institutions started out or still are for-profit, with dedicated programs and leaders who do not behave in that fashion and often hold 2-3 main positions to be able to make the income necessary to keep such a college going. I was President, director of education, lead clinic supervisor in my French meridian style, senior lecturer, grand rounds presenter, AND taught all around the nation and in Europe when raising a family. As a sole shareholder since 2010, I have worked to lower my salary while maintaining such a schedule so as to bring on the next leadership from within, and our lead administrators who are also didactic and clinical faculty do the same. When one works 3 jobs and some 80 hours a week, it is not unusual to make a good living, something CAN should appreciate with its own entrepreneurial model in fact.
And if we allow acupuncture to only offer USDE recognized 3-year masters in acupuncture since 1987 (or 4-year masters in Oriental medicine since 1994) standards while professions like physical therapy and pharmacy go to the entry level doctorate, it will situate us at a level far lower than I believe we deserve to be.
With ACAOM’s courageous work to correct for a politically manipulated ‘loss’ of M/Ac admission standards in 2009, for a program in acupuncture within the DAOM program standards, which were consensually adopted and integrated into ACAOM online manual standards in 2006-8 which took 10 months and came from our college’s request that this be corrected the USDE recognized First Professional Masters in Acupuncture (3-years) with the option of a piggy-backed 18-month USDE recognized Post Professional DAOM focused in acupuncture alone [or in any other AOM areas except Chinese herbology coming in with the M/Ac plus 45-hours Chinese herbology] means “the beginnings and the end” as the LING SHU would say, are laid out and entry-level credible standards that have stood the test of time for 27 years, plus post entry-level doctoral standards exist that will carry out field for another 3 decades easily.
The ISSUE is how a small group of Marxist ideologues are growing panicked at the loss of any posture for an ‘Oriental Medicine’ profession in California as I share below, and how some non-ACAOM accredited institutions are doing everything they can and going around ACAOM FPD standards some of us worked hard to make solid and get adopted, to in fact cash in fast on an inferior ‘transitional’ First Professional Doctorate by going around ACAOM by getting their programs folded into their regional (WASC, Middle States, etc) with no scrutiny of the quality of the new doctoral program. By the time the dust settles many people will sport a new DAc or OMD degree that required very little if any work, thus making that First Professional Doctorate as suspect as it was in CA from 1982 to 1996 when ACAOM, with new Masters in Oriental Medicine standards, started cracking down on such bogus degree programs.
This is only possible when new accreditation standards are at play (being ‘piloted’) which is always the case at first, and ACAOM will not be able to apply to USDE for FPD standards to be recognized as well until it has applied those adopted FPD standards to awarding candidacy to one non-profit school FPD program, or one accredited one in a for-profit school. It takes about 2-3 more years minimum to go from candidacy to full accreditation, so for-profit schools – and their students, have to wait that much longer before gaining access to federal Title IV financial aid funds. And if these CA and MD state non-ACAOM accredited institutions refuse to use ACAOM FPD standards and fail to get ACAOM substantive change approval – moving on to candidacy and then accreditation (which ALL entry-level masters and post masters DAOM programs have done up until now), this seems to be aimed at hurting ACAOM’s prospects of gaining USDE recognition for the FPD.
So while CAN attacked the FPD as if IT were the problem, as well as those who worked for solid standards adoption, a few California Acupuncture Board approved programs [biased against 3-year M/Ac programs] within non-ACAOM accredited institutions seem to have planned behind the scenes to do what CAN feared, and run such bogus programs for their sole profit, selling diplomas rather than providing solid doctoral level training for those who seek it.
This model, or a rigorous required entry-level 3-year masters, with an optional 18-month (4 semester) post entry-level doctorate is the model of nursing practice (nurse practitioners, nurse midwives etcetera) and tends to bring in current AOM college faculty who wish to upgrade their training for a long career in AOM education, and also brings back older highly experienced professionals ready for advanced training, eager to be part of the training of the next generations of masters entry-level professionals, with whom they work as Clinical Teaching Assistants, clinical tutors, advisors and mentors, thus passing on what they have cherished in this work.
The 2014 THE DOCTOR OF NURSING PRACTICE ESSENTIALS by Zaccagnini and White was the model the Tri-State College of Acupuncture chose to inform its successful substantive change application to ACAOM for a DAOM program in various styles of acupuncture.
I have watched with admiration how Maryland practitioners, starting with Bob Duggan, former TAI president, a founding ACAOM commissioner and first Chair of the MD acupuncture regulatory board argued for their academic and political rights to teach, study and practice a stye other than the politically freighted California Acupuncture Board programmatic model (4-year Masters in Oriental Medicine with integrated acupuncture and herbology defined in ACAOM standards as “the use of Oriental herbs in the context of Oriental Medicine”, which strikes up against FDA requirements regarding such herbal products, where no one may “claim to diagnose, treat, cure or prevent any disease” unless licensed as a medical PCP provider.
In 2005 after posturing that the profession in California is primary care practice of ‘Oriental Medicine’, and under more and more strict State Senate oversight, the California Acupuncture Board (CAB) was forced to restrict its public website consumer page to the actual law and a recent 2005 amendment which simply allows licensed acupuncturists, and anyone else not licensed in acupuncture, including any other licensed professionals, to do all manner of non-acupuncture AOM practices including such use of herbal products – NOT “in the context of Oriental medicine” as ACAOM masters in Oriental medicine and stand-alone 710-hour Chinese herbology standards (currently in revision by an ACAOM Masters Task Force), BUT as an adjunct to licensed acupuncture professional practice “to promote, maintain and restore health”.
Here is that amendment from 2005:
4925. (a) This chapter constitutes the chapter on acupuncture of the Business and Professions Code.
(d) “Acupuncture” means the stimulation of a certain point or points on or near the surface of the body by the insertion of needles to prevent or modify the perception of pain or to normalize physiological functions, including pain control, for the treatment of certain diseases or dysfunctions of the body and includes the techniques of electroacupuncture, cupping, and moxibustion.
4937. An acupuncturist’s license authorizes the holder thereof: (a) To engage in the practice of acupuncture. (b) To perform or prescribe the use of Asian massage, acupressure, breathing techniques, exercise, heat, cold, magnets, nutrition, diet, herbs, plant, animal, and mineral products, and dietary supplements to promote, maintain, and restore health. Nothing in this section prohibits any person who does not possess an acupuncturist’s license or another license as a healing arts practitioner from performing, or prescribing the use of any modality listed in this subdivision.
While old AAOM forces for the CAB-only 4-year Oriental Medicine model are still lobbying in NYS for the 15th failed time for the supposed CAB model, they have not informed anyone that THAT Oriental Medicine model totally failed in California almost 10 years ago. And while they decry NYSED’s position that while anyone can do such practice of Chinese ‘health food’ under FDA regulations for such products under a separate business, licensed acupuncturists cannot do it unless they get such a separate business ( a 5-minute process at any bank), it is functionally identical to the BEST that AAOM forces could muster in their own state of California, where those critical oversight Senate forces have weighed in very favorably on eventually having CAB use ACAOM program standards and approval processes for that state. And ACAOM’s current work to finalize adoption of reconceptualized masters standards is not looking to adopt sole CAB ones (for a 4-year integrated acupuncture and herbal medicine program), but rather to simply make the standards comply with USDE preferred outcome and competency-based criteria. it should be noted that thanks to non-CAB programs from MD, IL, WA,FL, MA, CT, NY, NJ, and elsewhere, ACAOM started from, and never waivered on its mission of supporting academic freedom and diversity in AOM education that allows ACAOM accredited colleges and ACAOM accredited programs to teach whatever styles it wishes of acupuncture or of East-Asian herbology.
The NCCAOM, on the other hand, has moved away from competency-based standards and passed over its practical written and practical Clean Needle Technique (CNT) course/test which states greatly appreciated, and its Point Location Practical Examination (PLPE) which we commissioners developed in a 40-person focus group with practiitioners from all traditions we knew of at that time (1988 or so), and more and more rigidly defended its 3 multiple-choice examinations in a TCM biased acupuncture certification model in a failed effort for over 2 decades to get the California Acupuncture Board to adopt it. The state of Maryland on the other hand, just argued again to their acupuncture regulatory board there to allow graduation from an ACAOM accredited program (in any styles) due to the biased TCM nature of the NCAOM examinations OR NCCAOM acupuncture certification; which could become a model for the nation in non-CAB programs and especially the 41 out of 62 ACAOM accredited colleges, if they started to speak up with a singe voice citing the Maryland example of over 30 years already.
The Tri-State College of Acupuncture I founded in 1982 petitioned ACAOM exactly a year ago, to correct for inadvertent dropping of admission standards for a program in acupuncture in 2009/2012 online accreditation manual standards, and was the first DAOM doctoral program substantive change application to have gone through those revised standards open to M/Ac applicants.
Just as CAB was forced to edit the scope expansionist and inaccurate term “Oriental Medicine” to read “Acupuncture & Oriental Medicine” in its 2005 and current standards, ACAOM’s current Hot News website version of the revised standards adopted 8/17/14 and published a month later show in colored edits that ACAOM commissioners also PUT THE ACUPUNCTURE BACK, and so any of the current 10 or so ACAOM accredited DAOM programs, and any new ones may apply to also take in Masters in Acupuncture graduates with just a 45-hour introduction to Chinese herbology for an advanced doctoral training in any styles of acupuncture-moxibustion, with doctoral specializations in ANY AOM areas [except Chinese herbology, whose applicants would be required to have the masters in Oriental medicine or equivalent 710-hours of Chinese herbology training].
It should be noted that current ACAOM masters FIRST PROFESSIONAL/ entry-level standards in primary acupuncture (3-year M/Ac) and in AOM (4-year M/OM) are USDE recognized, since 1987, as are DAOM standards since 2013.
So while some non-ACAOM accredited institutions in CA and MD are advertising First Professional Doctoral (FPD) Programs that do not adhere to ACAOM adopted FPD standards (which call for at least a year or more in residence for any transfer into the 4-year FPD Program), by going through their regional accreditation agency – with no effort to undergo the rigorous ACAOM substantive change processes required of any ACAOM accredited masters program [to ensure that such new doctoral programs do not negatively impact the core masters entry-level masters program], the other 41 ACAOM accredited colleges, which are all dedicated solely to quality AOM education and practice must adhere to such ACAOM standards and processes which have met stringent USDE regulations.
A new doctoral program has just hit the open market, namely an 18-month DAOM open for the first time to any masters in acupuncture graduates with 45-hours of Chinese herbology, that the council of colleges, CCAOM tried to prevent to the sole benefit of CAB 4-year M/OM graduates [CCAOM promoted the false belief on its website Q&A page until 2 months ago when some of us found out this was posted for some 12 years already, for any prospective student to view and be influenced by, stating categorically that any masters/doctoral program combination had to total 4,000 hours, making the DAOM open only to M/OM graduates of the CAB model!].
It is imperative that new leaders stand up for the right to practice the forms of acupuncture-moxibustion, and herbology they trained in according to ACAOM USDE recognized standards that have never precribed the sole TCM model.
TAI argued successfully to their MD acupuncture board against being forced to train their students in such Marxist politically correct ideology from the mid-1980’s on, and the “laboring masses” and students of PRC followed suit from 1987 onward, for the right to access their own local practitioners trained in a plurality of styles and for the right to once again read and practice all manner of Confucian, Daoist and Chan Buddhist self cultivation and nurturing life practices that speak to the art of this medicine originally known a early as the LING SHU as “yidao” – the Way of medicine.
It would seem better to be sure our political critiques are rooted in facts, and that we who love these AOM practices, and especially acupuncture as it has survived transplantation in North American soil, learn to communicate again from this love of what we do, rooted in the Way of medicine – yidao.
All ideas here are my own and have nothing to do with any other organization or program.
Thank you for this new venue,
Mark Seem, PhD, LAc
This is a link to article giving background for DoE actions re’ for profit schools. While there is not mention of acupuncture programs, for profit schools are exactly that. The ACAOM writing a letter that defends for profit acupuncture schools never takes into account these predatory practices that can and do occur in our profession.
ACAOM’s letter also takes issue with the DOE making a distinction between non-profit and for-profit schools. Of course, they were using it to argue that no type of school should be held responsible for student’s ability to pay off their loans. I could argue that all schools should be held responsible. But I did read something written by one of the people who worked on the policy, and she pointed out that non-profit schools are run by boards of trustees. While investors in a for-profit school have a financial reward for bringing in as much money as possible, non-profit trustees don’t (if everything is kosher). It made sense to me.
BTW — petition signatures are at about 225. Over 1000 people signed the petition about dry needling in Maryland. Interesting — we’re far more willing to complain about what some other profession is doing than to even ask our institutions to take responsibility for their role in the profession’s challenges.
Couldn’t agree more, Elaine.
I’ve signed the petition and hope lots more do, too.
Adding degrees and letters to a name is a way for institutions to get money. It won’t make anyone a better acupuncturist.
“Will the NCCAOM require an FPD to sit their exams? Will the alphabets encourage states to require it for licensure?”
That, Elaine, is a key question. I think that what you are predicting here may be a long way off since the compounding of the problems associated with the cost of education, the dysfunctionality of our institutions, the engineering of state laws and regulations to restrain trade and shut out competition will not serve our collective best interests. Fortunately, I think that in the end even the denizens of the “realm of the acronyms” will soon recognize that moves that may well assure the destruction of our livelihoods are not in their best interests either. They want and need to hold onto their advantaged positions. Conflicts of interest can be seen everywhere in the system of relations that has developed.
Evidently the ‘big money’ is not in being an acupuncturist. That is well established by now. And while the NCCAOM may have served the very useful function of creating a means by which legislators could be assured they were not licensing quacks and loonies (at least in the early years after its creation) much of their activity now seems parasitic–that is, it is designed to generate income at our expense. Our most recent demographic report when viewed with an an eye that can see that the ways the survey results were presented distorts reality. Seen without these distortions the data shows that we are not doing well at all. Yet the head of the NCCAOM is paid a quarter million dollars a year in salary and benefits. This is, by the way, a salary that is quite out of keeping with the salaries of other non-profits controlling comparable assets. Anyone who does not believe me can go to Guidestar (http://www.guidestar.org/), register, and download their most recent form 990 IRS non-profit tax return (Fiscal year 2012 is the most recent).
There is now so much wrong with the institutionalization of Chinese Medicine in the US that one hardly knows where to begin. I think the work you are doing is important because very few understand the facts. I wonder how many practitioners who will never see an end to the cycle of debt they now find themselves in would have decided to proceed with their education knowing what they would be facing upon graduation. This all has to end–now!
I signed it in the beginning when it was first presented. It is completely disgusting the way our organizations have conducted themselves. I agree with everything written above. I have little faith things will change. Our organizations survive off of all the new practioners not the old ones. A lot of the old ones drop them because they are already established in there particular state and don’t need them anymore. I hope they do listen. It is terrible what has gone on.