(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.
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.