(Thank you, Matt Bauer, for giving us permission to post your article on the CAN blog page.)  I want to offer my opinion on the First Professional Doctorate (FPD) and why I am opposed to moving forward with this plan at this time. As you will see, my opposition to the FPD is directly tied to my belief that there is a much more pressing issue the Acupuncture and Oriental Medicine (A/OM) profession should be undertaking right now.

What if I told you that there was a project the A/OM profession could carry-out that would do more to unite our profession than anything else we could do rather than dividing us as the FPD is doing? What if I also told you this project was the best possible way to directly benefit A/OM practitioners and the public by generating hundreds of thousands of new patients seeking-out A/OM services? What if I told you that in the process of carrying-out this project, it would build our professional associations by putting new patients in their members’ waiting rooms, generating gratitude and support toward those associations? What if I told you this project would help our schools by allowing them to tell prospective students something they cannot honestly tell them now: “Come, join our profession and enjoy a stable income while helping others.” And what if I told you this project was completely within our means and would start paying dividends within months? Don’t you think such a project should take priority over those like the FPD that take years to accomplish their goals and drain much of our profession’s resources? The project I am referring to is a comprehensive public outreach campaign.

Many Americans are interested in acupuncture but know very little about it or other aspects of Oriental Medicine. They know even less about those who would be poking needles in them. Most Americans don’t even know that acupuncturists need a license to practice! This lack of understanding has greatly damaged the growth of the A/OM field especially individual practices. When I would point this out to different leaders of A/OM organizations over the years, they all told me they thought public education was important but most their efforts to address this problem ended-up targeted in the wrong direction. There have been several efforts made to educate political, insurance industry, and medical leaders about A/OM but absolutely no coordinated campaign to directly educate the public. In other words, we have been following a top-down approach; lobbying leaders in the hope they will change policies that will eventually trickle-down to benefit the public and practitioners. Evidence shows these efforts have failed to generate an adequate patient-base for A/OM practitioners leading to many failed practices.

In the National Certification Commission for Acupuncture and Oriental Medicine’s 2008 Job Training Analysis (JTA) of NCCAOM Diplomats, they found nearly 90% of respondents to their survey (88%) were in solo private practice and that the average annual gross income for all respondents was between $41,000 to $60,000. 70.1% grossed under $61,000, 21.1% grossed between $61,000 to $120,000, and just 8.8% grossed over $121,000. When you are in private practice, a pretty good chunk of your gross income – at least 25% to 40% – is eaten-up by expenses such as rent, utilities, advertising, supplies, insurance, etc. When you subtract those expenses from the gross income, this brings the average before tax income of nearly three out of four Licensed Acupuncturists to somewhere in the $30,000 to $40,000 a year range at best. It is hard to imagine enjoying a comfortable living on those wages especially considering that 50% of those surveyed were carrying an average of $40,000 in student loans from their schooling.

These dismal statistics show relying on the top-down approach alone is not working. We spend most of our resources lobbying politicians and fighting amongst ourselves over things like education standards and then spend almost nothing on reaching-out directly to the public. The dental profession has an outreach program with their 1-800-DENTIST campaign. Why do the dentists do this? Because they know people are afraid to go to just any dentist so they work at making the public feel more secure in making first contact. If the public is worried about selecting a dentist they don’t know, imagine how they feel about seeking an acupuncturist, especially considering they know nothing about our training. Yet despite this glaring need to reach-out to the public, we dedicate no resources to directly easing that fear. There is no reason why the A/OM profession couldn’t have its own outreach campaign.

It’s said: “Where there is a will, there is a way” but up to this point there has been a lack of will within our leadership to make this type of public campaign a priority. Think about what happens when there is a positive story about acupuncture on T.V. or in some magazine. Many acupuncturists start getting phone calls from people wanting to know more. Virtually all of these media reports about acupuncture take place spontaneously because some media person thinks such reports would be of interest to their viewers or readers. Now imagine how much more publicity could be generated within the media if our A/OM organizations were devoting themselves to developing a comprehensive media campaign. It is foolish to just wait for these things to happen by themselves, we should be making this happen. Acupuncture is newsworthy. People are fascinated by it. We need to cultivate this interest and get our message out there in a coordinated way.

Taking Responsibility

When you understand the organizational infrastructure of the A/OM profession, it is clear just what organizations should be responsible for a public outreach campaign: the professional associations and schools. As our lone national professional membership organization, the AAAOM should be taking the lead in this campaign together with state professional organizations and with the help and financial backing of the schools. These groups have consistently put most of their resources in the top-down approach so making public-outreach a priority will require a change in their traditional mindset. The emphasis on the FPD issue is a good example of why this mindset needs to change.

The most compelling rational given for undertaking the huge effort of establishing the FPD is that it will better prepare those with that training to work within the mainstream medical system, especially within integrative medical establishments. While this goal is certainly laudable, it shows a complete lack of awareness of the realities facing the A/OM profession today. The NCCAOM’S JTA found 88% of acupuncturists are working in private practice and only 12% are employed in hospitals, multi-disciplinary centers, schools, and the like. What the leaders of the FPD movement are saying is that they want to expand this 12% to make it possible for more A/OM professionals to have those types of jobs. The problem with this approach is that it does nothing to help the 88% out there today in private practices who struggle to keep their heads above water. The FPD is a complex, multi-year undertaking that holds the hope of creating more opportunities some day in the future. Pinning our hopes for growth by focusing our limited resources on future hospital and integrative center jobs is essentially giving-up on supporting private practice. We end-up putting everything into growing the 12% instead of helping the 88%.

If our profession was seeing most of our A/OM schools’ graduates transitioning into successful private practice, then it would make sense to try to build the job base currently enjoyed by that 12%. I am all for integrative center and hospital jobs for A/OM professionals but our resources are limited and this is not the most pressing issue our profession faces. We are ignoring the issue of putting patients in A/OM practitioner’s waiting rooms today in favor of those future jobs. We need to shift a healthy share of our resources to direct public outreach. Getting patients into waiting rooms is something we could see start to happen with a few months of a public outreach campaign and this would help the three out of four practitioners who are struggling right now.

Our organizations’ leaders will undoubtedly say that we don’t have the money to do any education/marketing but this shows a lack of vision. We have some 60 acupuncture schools today and if each were contributing just $500 and month over the next few years, this would give us a $30,000 a month budget. I guarantee you we could put hundreds of thousands of patients in practitioners’ waiting rooms over the next few years with that budget. Even if we had less money available to us, it won’t take a lot of money to make great strides in promoting A/OM directly to the public. Getting articles published in the print and electronic media is more about planning than money. We could accomplish a great deal with innovative marketing campaigns on very modest budgets that will translate as more patients for more practitioners today.

Students and alumni of schools and members of professional associations need to ask the leaders of these institutions why they have seen fit to leave public outreach for another day while so many A/OM professionals are hurting. Start demanding more be done on this issue. Consider the A/OM profession like you would a patient. When treating patients, one needs to learn when to shift the focus of the treatment to address the changing levels of imbalances. The A/OM profession needed the top down approach in our early years to make us a legal profession in most states and establish our infrastructure with regulators. We should all be very appreciative of the work that was done to establish this infrastructure, but it is now time to shift the focus of our efforts to direct outreach to the public. You remember the public. They are the ones our efforts were supposed to be about in the first place.

Jessica Feltz
Author: Jessica Feltz

<p> I learned about Community Acupuncture while studying at the Midwest College of Oriental Medicine (MCOM) in the Spring of 2006 when Lisa Rohleder's first article about her clinic appeared in Acupuncture Today. Coming from a middle-class background myself, I was the only student in my acupuncture class to have not experienced the healing benefits of this medicine prior to beginning studies at MCOM. I couldn't afford it. And my family couldn't understand what I was doing by investing in an education that they didn't perceive to be financially sustainable. </p> <p> The Community Acupuncture model is a perfect fit for me, balancing social justice and taoist simplicity with the patient's innate ability to heal him/herself (with a few gentle nudges from strategically placed needles). I am grateful every day to have found CAN and the love it brings into my life. I want to share that joy by spreading the message about how we can create a new health care experience in our communities through each of our very small efforts...and how those very small efforts can in turn change the world. </p> I enjoy my two sons, my 4 cats, and big stacks of books.  I own and operate...

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  1. Matthew, I love the idea of an educational/marketing campaign!

    My God, look at what that’s done for pharmaceutical companies: Remember the “little purple pill” campaign? More than 7 million Americans now take Nexium, and IMS Health reports that it earned more than $5 billion in US sales in 2006. All from an educational/marketing campaign that told them to ask their doctors about the “little purple pill.”

    Nexium’s advertising campaign didn’t describe what the pill did or who would benefit from it. The campaign didn’t discuss the side effects or risks of the pill. The campaign didn’t tell the public how long the pill had been in trials, or what kind of testing it had undergone, or what the results of various studies were.

    The public doesn’t care about any of that.

    In the same way, our patients (i.e. consumers) do not care how long we have been in school, or what classes we have taken, what our degree is, or even what the results of various studies are. They do not care if we operate in hospitals or community clinics. None of the things that this FPD campaign are focused on will have any bearing on the general public’s awareness or usage of acupuncture.

    But imagine what an educational/marketing campaign could do!

    Think about the “Milk.  It does a body good.” commercials.  In the 1980’s, the Dairy Board’s advertising agency designed a campaign around this message, because consumption of milk had been steadily declining at a startling rate. Within 36 months it had reversed the trend, and milk’s share in total beverage consumption rose for the first time in five years. 

    Why on earth hasn’t this been discussed before in the acupuncture establishment??? Many community acupuncture clinics have already implemented brilliant local campaigns in their towns with minimal budgets…this should be a no-brainer for the orgs.

    Now is the time to shift the focus of our efforts to direct outreach to the public. You remember the public. They are the ones our efforts were supposed to be about in the first place.” Here, here! Thank you for the contribution, Matthew.

  2. Jessica I think you should be our national

    publicity campaign leader.  You have all the right savvy and drive for the job.  Since all we acupuncturists seem to do is create jobs for ourselves, maybe you could make this happen as well.  Carpe diem.  If I get to nominate, you have my vote.

  3. Matthew

    I couldn’t agree with you more!  We need this to happen, and we need to use our resources for this purpose rather than on the dream that a FPD will magically solve all of our problems.  I get daily phone calls from people asking me if acupuncture can help with their condition, often these conditions are simple pain or injury issues that seem like it should be obvious that acupuncture can help.  The general public just doesn’t know what we do, but in my experience they are very curious and would love to hear more about acupuncture.

    I can’t agree that many potential patients don’t care at all about our education, I am often asked what sort of training I have, we are sticking needles in people, that’s a big deal to many people, especially here in MI where there are few acupuncturists and many people haven’t been exposed to it.  I do agree completely that they don’t care if we are doctors, every single person who has asked me was more than happy with my credentials, they just want to know that their acupuncturist has been trained to practice safely and won’t hurt them, that can be part of the public education. 

    I’m baffled that so many in our professional leadership think pushing through the FPD is more important and a better use of limited resources than this.  An education campaign can start working for us immediately, and would likely show how unnecessary the FPD is for the purposes they say it is needed for.  

  4. Fear of the unknown

    Hi Linda,


    I was once having lunch with Barbara Mitchell, who was then
    head of the Acupuncture Alliance, she had been the founding head of the NCCAOM,
    and before that she had been instrumental in getting many states to adopt
    acupuncture licensing legislation. In other words she was one of the most
    influential people in the growth of A/OM and knew as much or more about this field
    than anyone. I was gently prodding her about getting her organization to do
    more on public education and told her that even here in California, the state with far more
    acupuncturists than any other, most people did not even know that you had to
    have a license to practice acupuncture. She was surprised by that claim and was
    skeptical. When I insisted it was the case she said she wanted to take in impromptu
    pole and stood and asked the table of 12-14 or so people eating beside us if
    she could ask them a question and asked how many thought a license was needed
    to practice acupuncture. Only a few at that table said they thought this was
    required. Barbara was surprised but never did take on public education as a
    priority of the Alliance.

    My point with all this is that most Americans think anyone
    that gets off the boat from China
    can put-out a shingle and call themselves an acupuncturist. If we do nothing
    more than get out the message that you have to be trained and licensed to
    practice acupuncture, that alone would make a world of difference. Of course,
    we should do more. We need to help people have less fear of the unknown –
    acupuncturists are unknown to most Americans. We need a “Meet Your Local Acupuncturist” campaign
    or along those lines. We need to take people by the hand and let them know
    seeking-out acupuncture is not a scary proposition. People are interested in
    acupuncture – they just don’t know anything about acupuncturists and that
    equates to fear.

  5. Wow Matthew


    thanks so much for your research and thoughtful balanced presentation on this subject! I especially liked the way you put our history in perspective and avoided demonizing anyone in the process.  It makes so much sense – it would give everyone (AOM organizations, practitioners, schools, etc) something concrete and manageable to do so we can move beyond fighting and stone throwing.  No doubt, sometimes its necessary to fight to clear the air, but there is a time to construct and build. Hopefully we’re moving towards that time.  And I agree with Tess, Jessica you would be great as the national campaign manager but better yet how about co managers – you and Matt!

  6. There is no time like the present

    Thanks for your support of this plan. It is really quite
    simple: we are a new profession practicing a healing system that is completely foreign
    to this culture and does not make any sense at all to accepted medical
    understanding. In order for this healing system and our profession to reach the
    fullest potential, we need to take-on the job of public education as a high
    priority. We need a multi-year commitment and the combined efforts of some of
    our best and brightest to make this happen but such an effort has never been
    seriously considered by our mainstream leadership. I just seek to bring this issue to that
    leadership so it can be given the attention it deserves.



  7. we may be rude

    but we’re not dumb. We appreciate lucidity when we see it, especially since we see it so rarely. Thank you for your work on this. We appreciate work too.

  8. Brilliant

    Well done!  This makes total sense.  How can we help you get this to the right people?  I will print it out and give it to Benjamin D. myself, for starters.


    Lisa, I think we need to make some bumper stickers… “We may be rude, but we’re not dumb”  — or how about that for the back of the next CAN teeshirt?


    Julia in Berkeley

  9. I’ll mention this article in my anti-fpd letter

    to the multi-letter org’n. I think it’s a good idea for others to do the same.

    “Students and alumni of schools and members of professional associations need to ask the leaders of these institutions why they have seen fit to leave public outreach for another day while so many A/OM professionals are hurting. Start demanding more be done on this issue.”    Exactly.

  10. Educating the public is key

    I think this gets to the key of a lot of the FPD debates.

    People think the FPD will give them more legitimacy to get start up loans for their business.


    A doctorate is not going to get you start up loans. There are plenty of new fangled phD degrees in things people have never heard of and try getting a loan from a bank with one of those.

    Start up loans will only come with education. So the general public knows what acupuncture is, have tried acupuncture, know a little about licensing and education, and know acupuncturists that have succeeded.

    Start up loans will only come with data. Data about success rates of clinics in our profession.


    I am very very lucky for the CA model. It has enabled me to succeed in a community where acupuncturists have come and gone because they couldn’t make it.

    (On the upside I’ve got a lot of people rooting for my success here. Lots of people telling everyone they know because they don’t want me to fail and leave)

    Education of the public is key and CA is sooo good for that. Because of our numbers. It enables many more people to know and love acupuncture. It’s the differences between providing 60 treatments a week at a BA practice and 140 at a CA practice.

    I love my Free Days. I know free treatments don’t pay the bills, but every free treatment I give at a talk or anywhere enables one more person to be exposed to acupuncture as a legitimate practice.

    And I’ll talk to ANYONE about acupuncture, I have spoken to college students. I will speak to high schoolers. I’ll probably speak to kindergarteners if anyone ever invites me. I know that a ton of high schoolers or kindergarteners are not going to come walking in my door, but at least they’ve been exposed to acupuncture.

    Education is key. Not more education for us. But a lot more education for the public. That will help our legitimacy problem more than anything else.


    Jade Community Acupuncture, Winona, MN