Chickens Coming Home To Roost

 Acu-schools

In the greater economic world there’s a truism that in a recession colleges do well because more people enroll.  It’s a truism because that’s what’s happened in past recessions; it’s well documented. However from my talking with Acupunks and reading emails and blog entries I think this recession will not be so favorable to Acu-schools: they will at most stay even and probably several (or more) will fail. Needless to say for private practitioners the failure rate will increase over the already bad 50%-80% that already exists.

 The base reason why I am pessimistic on the short-term growth of the Acupuncture profession is that to me all the signs point to a market correction. There’s just so much flab while at the same time the debt load is huge with the profit margin small. I wish I could point to some studies on this but there are none and that fact is part of the problem. Acu-schools have traditionally kept their enrollment figures and their budgets to themselves or at the most shared them with friends at other schools. Thus it’s very difficult to get a clear picture. Even getting a simple number like the number of licensed Acupunks in the country is elusive, much less the number of actively practicing ‘Punks. But take this anecdotal evidence from Acupuncture Today and the Talk Back forum for Felice Dunas.  Those responses plus info I’ve read that some Acu-schools are a) accepting every applicant they get (meaning they aren’t making their quota), and b) Acu-schools are having newly enrolled students leaving after one term thus driving the schools to cut costs so they don’t go into the red shows to me that almost all of the schools are right on the edge financially. That this is not a change from a year and a half ago when the Santa Barbara school abruptly closed its doors tells me that this recession will be no friend to the schools. The message is out that becoming an Acupuncturist is not a way to make a good living.

Private Practitioners

That the recession will spell trouble to private practitioners should not be a surprise. Neither should the prediction that boutique practices, particularly those who rely on herbal and supplement sales, will also feel the pinch.  In fact one president of one of the larger Acu-schools has already said in a private on-line forum that the recession is hurting those practitioners. (Again, what drives me crazy is the secretive nature of the state of our profession. In the last couple of workshops that WCA has led we have heard from several attendees how different it is compared to other workshops where the Acupunks were competing with each other. Its a shame.)

————–

So in taking what seems to be happening with both private practitioners and the schools, it looks to me like we are getting a market correction that will weed out both schools and private practices that to me have a lot of fat: they cost a lot and return little. In spite of the recession people will be hesitant to enroll since the word is out now of debt loads of $100,000 with a good chance of not making a large income (that elusive $100,000 annual income that some schools have promised their students). 

Already a couple of schools have approached WCA about how to teach CA. And in last weekend’s WCA workshop in Boston we had more than a few attendees who used to have profit making boutique practices looking to change to CA because they are now losing money.  They are desperate. (It used to be that almost all WCA workshop participants wanted to learn to do a CA practice because they felt philosophically attuned to WCA’s stance. That is less the case now.)

We (WCA) are also getting practitioners who are thinking that they are doing CA but failing and wondering why with the answer being that what the are doing is CA in name only. The practitioners here at CAN who know how to run a successful CA practice (which again is not everyone) know that the mindset of running a CA is quite different than running a BA (boutique clinic) but most Acupuncturists don’t know that. Thus it’s up to us successful CA practitioners to state plainly and firmly (while being polite of course Laughing) what it means to be a successful CA, including understanding and appreciating class differences- which the great majority of Acupunks don’t (and many won’t).

I have some hope that in five years this market correction will shape our profession into one that will stand a chance at growing to be a real part of American healthcare. First though those chickens that we sent out for years- high prices, elite boutique spa treatments, faux western medical practices,and ignoring 79% of the American market- have to roost at home. The hope is that we as a profession will realize our dilemma.

In ending this post I just have to post a poem from Kay Ryan, Home To Roost:

The chickens

are circling and

blotting out the

day.  The sun is

bright, but the

 chickens are in

the way. Yes,

the sky is dark 

with chickens,

dense with them.

They turn and

then they turn

again. These

are the chickens

you let loose 

one at a time

and small-

various breeds.

Now they have

come home

to roost-all 

the same kind

at the same speed. 


Skip Van Meter
Author: Skip Van Meter

Skip is Lead Acupuncturist and Co-Founder of <a href="https://www.workingclassacupuncture.org/" target="_blank">Working Class Acupuncture</a> in Portland, Oregon. With the earlier part of his life spent acquiring knowledge about geology, urban planning and teaching high school, he has now been an acupuncturist for 19 years, using about a 1,750,000 needles poking his patients. He likes all things soccer, has three fabulous sons, the best wife in the world, and a great dog and two cool cats.

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  1. It is interesting how we get

    It is interesting how we get the opportunity to see things circling around. So often, it happens so slowly, or so far away from where we wind up, that we never see it.

    I’ve had a really, really, really bad couple of days. There is something comforting in the idea that the people who have done so much to make my life hurt right now are likely to get it right back at them. More likely that not, that day will be pretty soon. When it does come, if I get a chance to see it, how will I act? What will I do? I think this is a real measure of a person.

  2. been there, done that market correction

    same thing happened to massage schools and massage grads after the towers fell.  many businesses were affected besides massage schools, but i was just thinking of that as a somewhat relevant example. acu-school and being an acupunk is a different animal than massage school (more debt, more time investment for acu-school, and massages are  more of a luxury item for most folks), but the idea about BP/PP and spa treatment prices is the same in my mind.  customers were more reluctant to spend the money for massage (and many other things) at that time. 

    Recently also there have been posts on CAN about how acupuncture schools make a lot of money from the students. Skip makes a very good point, this really isn’t true in some school’s cases (even the big ones), at least in my experience. it’s hard to make it as a school. if the schools were more transparent and made public their real financials, it would be a shock to some that many are actually still in business, and not for lack of good business stewardship.  moreover, if you think it’s funny how schools find a way to tap student pocketbooks in different ways, the school is just a medium size fish.  one of the crazy things for schools is the constant outflow of cash and fees to bigger fish like ACAOM, NCCAOM, state licensing agencies, etc.  it’s a crazy food chain.  the only thing that keeps many schools afloat is federal financial aid and the influx of warm bodies in the lecture hall.

    my two cents about the future of our profession is that the number of practicing acupuncturists will continue to decline in the coming years, or at best stay level. 

    many thanks to Ann for the first survey and compilation of results, when more of our CAN clinics show how successful this model is, and we hire more punks, the proof will be there, and the community model will lead the way into the future.   

    thank you  Skip as always for your insight and reflections.

    k rizzle 

  3. Re; The Chicken Count

    Skip

         Do you really know what you’re talking about with respect to declining admissions in the schools? Really…From where I sit in Northern California it seems that the ” good” schools are weathering the recession fairly well. Five Branches has been sucesssfully launching its graduate programs as well as a second campus. And I believe the southern california schools are fareing ok.

         So really Brother…where are you getting your facts?  I respect you and WCA very much…but you have alot of influence right now on alot of fledling practitioners….so please be responsible to what you are saying.

     

                               Turiya Hill, L.Ac.

                                 Nevada City, Ca.

  4. when the profession suffers Hi Skipall of us are affected

    Skip- I get that there is a sense of bitterness and frustration about the acupuncture practices that have traditionally run in the US. However, I do not see how the failure of the schools or anyone elses acupuncture practice helps the profession of acupuncture.

     Even when I did run a table acupuncture practice, I always kept my overhead as low as possible and charged what I felt my clients could afford, took insurance even when it only paid $35 a treatment (and sometimes less) so that I could make sure what I believed in was accessible to everyone (even before I ever heard of WCA). I have worked in public health most of my professional career (over 25 years) and have volunteered in various capacities since I was 11 years old- it is who I am. 

     With all of that, I still do not see how it furthers our profession to have the folks that charge the usual fees for the medical profession ($80 to $125 per visit) fail. The recession (I would go as far as to say it is probably going to end up being viewed in the history books as a depression before all the dust settles) is hurtful to all of us.

    Let us spread the word about affordable health care without maligning the efforts of others.

     

     

  5.    Skip’s post hit

     

     

     

    Skip’s post hit pretty close to home for me and I imagine alot of others…

     

    Before going to acupunk school I attempted to research the kind of income I might expect to make. After all, I wanted to make an educated decision before going into debt. Right? At that time- 2003- I could only find statistics on professions like chiropractors, doctors, occupational therapists and the like.   How strange at the time I thought that I couldn’t find acupuncturist facts and figures. Not one to be deterred I decided regardless, that I wanted to be an acupunk. So fast forward a couple years and here I am as a co-founder of a community acupuncture clinic.  Rewarding work, love the work and basically paying my bills. But starting a new career laden with student debt is doubly difficult.   I made the leap from student to practitioner because that was my only choice.

    The rude awakening for me is the realization that my income potential as an acupunk might not be commensurate to amount of debt I incurred.  Hmmmm…

    I think CA is ahead of the wave in these difficult times but I wonder if even that will be enough to pay off loan debt.  It’s going to take a lot of creativity and maybe even some fancy footwork to get outta this one. 

    -Joseph 

  6. What about school clinics?

    The nice thing about CA is that you don’t have to worry about competition (as much) and can have a more inclusive and cooperative approach to our profession. It would be great if the recession prompted more acupunks to charge affordable rates, but what about the school clinics that are serving the community as well.

    My Acu-school (NIAOM) went belly up in my 3rd year (2003) and we had to finish up at a different school. It was VERY sad to see a highly acclaimed institution fail. There is no alumni association anymore and our school records are in storage somewhere out there. Our school is nothing but a ghost now.

    The most tragic part of the whole experience was seeing the school clinic close, as well as a dozen or so external clinics that served the underserved. These were the only places at the time that offered affordable acupuncture to the public, and all of those patients (and there were a lot) lost a valuable source of healthcare.

    Yes, schools charge a lot for tuition and I’ll be paying my loans off until I’m dead, but there is usually a community of students, teachers and patients that are part of a school’s community. It is them that lose out when the doors close.

  7. Definitely

     

     Good points, Rob! The schools are a vital part of our profession and having them suffer affects us all.  NIAOM was a great school IMO, I regretted not going there when I was in school.

     

    -Skip ———————–

     

    Mal: Well look at this. Seems we got here just in the nick of time! What does that make us?

    Zoë: Big damn heroes, sir.

    Mal: Ain’t we just.

  8. school loan debt

    Hi Joseph

     School loan debt is a hard reality for most professions these days. When I worked at Bastyr Clinic lab, over 6 years ago, the naturopath students were racking up arpund $100,000.00 in debt for their degree. There seems to be a shortage in doctors and physician assistants (I see this cause I work in a clinic that mostly hires these types of practitioners) and other skilled health care workers these days. Not only is the cost of education going sky high-the loan institutions are going under and it is harder and harder to get loans.

    The way I figure it, some people go into debt over $40,000 for a f*ing car-my  little red sports car was a masters degree in Chinese medicine. Sure, I will never pay off my school loan-frankly my dear. I do not give a damn.

    So, live the “American” dream-be in debt-like everyone else and try not to worry about that part.

    What you are devoting your life to has a lofty purpose and will bring you satisfaction in the long. Keep on keeping on….

  9. Here’s where I grumble with

    Here’s where I grumble with a grudging air about how my school’s clinic charged the same high rates as many acupuncturists. ($65 bucks a session)

    That being said, I don’t suspect that this recession will close down the schools that do the best at catering to the rich. Its the poor and the working class that are bearing the brunt of this economic recession. The wealthiest people in our country are doing great.

    Grumble.

  10. We have spies

    Can’t reveal them, or they wouldn’t be able to be spies anymore. Sorry. Cry

    No seriously, I have direct contacts with several schools and indirect contacts with a bunch more. Not 5 Branches though- and its great that they seemingly are doing well.  I also expect some schools to come out of this well even if the worst of my fears comes true.

    On the flip side, every school that I know of always says that they are doing just great! No problems at all!  Its all PR.

    But Keith above is right- almost all of the schools when they are living well are living on a narrow margin. There is very little cushion and I must say that most faculty members don’t recognize that fact.

  11. Totally agree with ya

    We need more acupuncture clinics, period.  We need healthy, lively schools. I believe there there is a huge demand for our profession if only we get our collective acts together. 

    I sure don’t want the possible winnowing that I see. Its just that I see it as very possible.

  12. My alma mater used to have

    My alma mater used to have an affordable student clinic. The prices have risen steadily to the point where they are much closer to private practices and well above CA rates. Furthermore, many off campus clinic sites have been dropped.  I take this as evidence that our school is scrambling to meet budget.

    When I first started, we were receiving Ryan White funding, and plenty of HIV patients where receiving free to almost free treatments.  The funding was lost, and so was the coverage.  

    Before I was a student, I was a patient at our clinic.  I paid $22/visit based on the sliding scale — which required proof of income.  Now days, the bottom of the scale has almost doubled.  I would love to post the exact figure, but they don’t post the rates any more (you need to call to enquire) so I can’t look it up at the moment.  

    I had the experience as an intern of seeing one of my patients in the lobby crying.  She was being treated for insomnia, and had improved to the point that she was finally getting 6 hrs of sleep for the first time in over a decade.  She was crying, because the front desk had informed her that her treatments would start to cost her close to $50/visit.  Her weekly treatments, were now out of reach for her, and she would need to start coming once or twice a month.  That was the same month I had discovered WCA and read the Remedy.  Her experience was what solidified my committment to CA.

    To this day, our school clinic has a sign in big letters declaring it a Community Clinic.  Bullshit.

     

    It is my hope that as CA becomes more of the norm, that schools start to adopt this model for teaching clinics.   

  13. i can hear the gallery now,

    “this guy is replying to his own reply. what a wacko.” well, call me crazy….

    in the words of Andy W, i am really not trying to sound like “Negatron” (maybe a cousin of Megatron? thanks Andy for coining that). I am very hopefully and cautiously optimistic that there will be no more sudden Santa Barbaras or IICM’s or NIAOM’s. IMHO, the national governing bodies of acupuncture and powers that be have a vested interest in the most positive publicity possible with no more schools closing unless
    any schools totally get fubar, it always looks bad when a school closes, we have what, maybe 55? in the nation. It’s like the financial system or the stock market, nobody wants to have people get panicky. we need schools, we need more Acks.

    I totally wish success for all the acu-grads, whatever the chosen path, PP, CA, or employed by hospitals or others, part time, full time ,whatever.

    i agree that the potential debt load is a big consideration for many potential Acks. i wonder what it would take to launch a CA oriented school and keep it running, sliding scale, grads make a commitment to CA for at least a certain number of years. maybe it could be the start of something sustainable like what Cuba has done with the community/neighborhood doctor program. maybe it could be a non-profit and get grants to keep running. just a thought or two.

    on another note, maybe as more CA clinics get successful we may be able to pool financial resources to help other CA’s get off the ground, that is, if startup costs hold people back.

    -k

     

     

  14. Like Warren Buffet said, it’s really about a war,

    a war between the rich and the poor classes, and he said, “and my class is winning.”

  15. living the dream

    Hi Jill,

    Thanks for responding to my post. I’m right there with you (thankful that my car is the one thing paid off), other then my question about what I am seeing now of a 35K income potential of an LAc vs. a 100,000 K + debt. the income to debt ratio is way out of proportion. Sure MD’s and PA’s aquire debt, but their income potential is on a different playing field. I am hoping to be proved wrong. meanwhile i’m keeping on keepin on…

    joseph

  16. Economy

    I actually agree with the economy discussion. But my opinions are just that, my opinions. I do not have facts to back my ideas that schools and others in our profession are, or will have increase money problems, I just think thats the case. Its the same as my financial person advising me on investments. They have opinions, but nobody can really tell what’s going to happen.

    I am interested in if school enrollment is down, and if acupuncturist are failing. I’m less interested in opinions in these subjects.

  17. the schools

    I worked in the admissions office of a natural health school for awhile, and saw directly how no one wants to talk about what’s really going on. No one wants to tell the prospective students that basically as long as they have the money or can get the loans to pay for school, they will be accepted to the programs. In 5 years I worked there I saw MAYBE 7-8 students be denied admissions, and they could barely hold a conversation. Why? Because the schools are having a hard time staying open! (I actually think this has a bit to do with the fact that alumnae are not suceeding, and therefore not giving $$ to their schools-the way many colleges and universities develop endowment funds).

    The few practitioners who have started supplement lines or have gone into writing and thus huge income streams are toted as typical when people call to ask about income potential. Its not fair, because its not true, and its like tricking people into coming to the school because the school needs the tuition, with no regard to the student’s wellbeing afterwards. Thats why its up to independent people out in the real world to get the information out there, so people can make informed decisions before they get themselves $100,000 into debt.

  18. Only in hindsight…

     Only in hindsight will we really be able to tell what’s happening now. Only after some schools close (and others open), after some people who graduated years prior fail to renew their licenses – only then will we be able to see what’s happening now. And we’ll probably be more interested in what’s going on then to care too much about a few years of history…

     I do think that the opinions of the many are worthwhile. People tend to have a group level of intuition that transcends the fears and doubts of individuals. Whether our economy is dipping or crashing, we all know and see (and probably, to some degree, are) people who are having a harder time making ends meet. From lower incomes and higher rents/mortgages, food and gas prices, we’re all cutting out the unnecessary.

     My wife is a pediatric physical therapist. She helps kids who have no head control or can’t sit or walk. Even some of her kids are getting fewer appts each month (appts that are paid in full by insurance) because they can’t pay for the gas to get there. Here again, we can talk about prioritizing health vs classism issues, but the data show that many people are cutting back.

     CA can help these people stay functioning (throughout these increasingly stressful times) without having to sacrifice a large part of their budget.

     Luxuries have always been marketed to the rich. They are and will be fine. The expansion and marketing of these luxuries to the rest of the population will suffer. (take the decline in sales of SUV’s as an example) Where we, as acupuncturists, can help and survive is by making our services affordable and educating people on the value of treatment. Some will join us, others will try to go the other way, or find their own way. All we can do is support each other as a profession, help the students (and schools) of ac make realistic, informed decisions about their futures, and do the best we can for our clients.

     We are definitely living in interesting times…

  19. Worth going Bankrupt?

    Ya know, I have been seriously thinking of attending a TCM school here in Colorado. I passed on this semester because of earning potential concerns. I am an avid patient and advocate for TCM. I am in healthcare currently and well respected and liked by patients. I like them too. I am 45 years old. The recession however has taken my job from me and may never return, at least to the status it was. Insurance companies have jipped me pretty badly. I am an Ophthalmic Tech. I give Eye exams. Anyways, I would love to be a TCM practitioner. But the debt I’ll incur is too much for the money I will make. I’v done the math. I don’t really have any debt currently. Just making the bills would be quite a struggle, and perhaps substantially more than my earnings can support. After reading this forum I’m even more convinced that a mediocre life and downright failure are a very real scenario. I could ruin my credit and go bankrupt even. I have researched this from a lot of sources. Most all tell the same tale. So why would I do this? I know a few practitioners that had school paid for up front, so they did not have debt after. How nice. If that were the case i’d probably jump in. That would make things easier! Why do the schools charge so much anyways. Because they can? That would not be right. Yea this CA thing will get a higher % of people treated with TCM. But at what expense to myself. I am feeling that places like CA will ruin the chances that someone like myself can get into the field and make a descent living. I don’t have the luxury to make 30-40k a year. School costs too much for that type of return. I will not be a martyr. I dont need much as I am a simple man with a wife and 2 dogs. The question here is: How can we make this work for all involved? And all who would like to be involved? I’d like to hear some comments.

  20. anybody out there?

    I have heard no responses to inquiries or questions with this blog thing here. Am I doing it wrong. I don’t blog much. Hello? I’m the last entry here called worth going bankrupt?

  21. This is a depression, despite stated economic parameters

    This is a almost unprecedented era in American history with only the Great Depression to compare our economic stress to. International bankers who have been friends tell me that this is their take on the current affairs.

    I do think that acupuncture schools are attempting to lead many of their students to believe that they will be earning 100 k in their early years out of school. This is not a reality except for a very elite few who are astonishing in their skills and knowledge. This is all part of marketing and increasing the likelihood of economic survival for acupuncture schools. The naturopathy grads have a higher debt in places like Bastyr and from the people I speak to, they are struggling to pay school debt and live within constrained means.

    As to the quality of acupuncture students, this is a hard curriculum and one would imagine it would scare away the less hardy. A true healer is a miraculous being and rare…still one would hope that such a soul might find his or her way into acupuncture school and keep us all enlightened.

  22. The rich are not as well off anymore

    We are seeing sales of luxury goods decline deeply and this means that the wealthier people are being deeply impacted by the stock exchange demise et al. Every sector is being affected except those that are still having funds availed to them.

    I believe that acupuncture schools should collaborate with every community organization to figure out how to help Americans access allopathic and alternative health care…acupuncture is an excellent candidate for preventive care in clinics that are in malls, corporate settings, clinics, etc. If we can’t earn a big salary, maybe we should instead opt for human well being in our very short human lifetimes on earth…and canvass our legislators to discount our $100k loans for public service.

  23. Will have more positive effects

    Hi, its nice to see lots of discussion around here, A recession is a hot topic nowadays. As everybody has to pass though the tough test of recession but I think it will too have more of positive effects, as we will learn to live under our hoods.

  24. Informative post

    Hi, this is something new to me that the schools do good at the time of recession. Apart from this a lot of informative message. Thanks for sharing it.

  25. bankrupt acupunk

    hi,

    i have been working on filing for belly up with the bank while i finish my LAc degree. been planning on acupunking, and having had a baby a year ago does make me second guess that. but for years i have not wanted to be a part of the bourgeoise, so i need to hold onto that. just want shelter (even if it becomes an RV), a place to grow food and have chickens, and health care.

    as for the debt, i hope it doesn’t land me in jail. otherwise, i will have great company.