strong>1) Looking at the recent NCCAOM Job Task Analysis, why do you think there are so few jobs for acupuncturists? What do you think that says about the acupuncture profession?
The NCCAOM JTA is a curious document because it attempts to say as little as possible about a very sad situation yet careful reading says it all. The only job for an LAc is solo practice. When reaching out to prospective students the schools make this sound like a business opportunity. The data say it is a business dead end. Lisa has summarized the facts here. Is it any wonder the leadership orgs have never put together a workforce survey? We see the unavoidable impulse to twist the data in the NCCAOM report where it is reported that 70% earn $60,000 or less per year. Huh? This is like those real estate investment ads on late night TV. Some people are making millions every month flipping homes. You could too! The NCCAOM JTA should have a photo of Kory Ward-Cook on a racing boat with a cigar and tanned LAcs in the background dancing to the groovy beat. “Seventy percent of LAcs make $60,000 or less!” Become a TCM doctor. Charge physician fees as a Chinese medicine physician. Complete your degree in 3 years. When people cannot earn a living, when as many as 40% of LAcs are making less than $20,000 a year the message should be clear. If it’s too good to be true…it ain’t true.
strong>2) What jobs for acupuncturists do you know of that fit the criteria of The Toaster Tour — real, relevant, and replicable? (See this blog post for an explanation of the criteria.) Please list the jobs, including the nature of the funding stream that supports them if you know it. We will try to independently verify them, of course; any contact information you have is greatly appreciated.
Best I can do is 2 out of 3. I met a CANner at the May 2011 conference who was working a Federally Qualified Health Center. He was being paid a salary. Without knowing much about him I know this. The job is real because FQHCs are supported by federal $$ to provide healthcare to indigent people. An FQHC can bill under an E&M code which means the clinic will get paid for practically any service delivered. It is relevant because he is treating every day poor people with primary care problems. This is not addiction medicine or auricular acupuncture or one of the other “branches.” This is medicine in a mainstream clinical setting. Unfortunately, it is not replicable. Could be but it would take some kind of coordinated work to make it happen nationwide. I hope he realizes how lucky and rare he is. A working LAc making a fair living in a fiscally stable setting.
strong>3) Who do you think is the largest employer of L.Acs in the U.S.? How many jobs does the largest employer provide?
Buzzzz. Loaded question. Not fair to the solo practitioners and their advocates. Everyone who doesn’t have their head in the sand should know the only org that is “hiring” is CAN. Every now and then my former student Simon Shapiro sends me a notice he gets from OCOM advertising for a p/t clinical supervisor at $10/hr. No wonder he went to med school at 36 y.o.
4) In your opinion, what groundwork needs to be done in order for more acupuncturists to have real jobs? Who is responsible for doing that groundwork?
I used to think that training needed to be grounded in primary care medicine. This means completing 6 to 9 months as a student working alongside physicians, RNs, NPs and PAs in a community clinic. I used to think that reforming acupuncture from within was the way to go. I am not so sure anymore. The problem is nobody cares about what happens to acupuncture; not mainstream medicine and certainly not the acupuncture schools or leadership orgs. There are certainly exceptions to my perception. Michael Jabbour is working very hard to reform AAAOM and ACAOM. NGAOM under the direction of Steve Paine and Hugh Morison are working hard to win contracts for Guild certified LAcs. The problem is the NCCAOM and the CCAOM want things to stay just like they are and have been. LAcs as a group are unable to organize. The best motivator is the ability to earn a living. The only avenue open is solo practice or independent practitioner. Even though going solo is sold as a great opportunity it is actually the only option available. Many “pros” talk a big game to promote their book or special skill set. The only measures that matter are hours worked and revenue generated. The only group I see that is sharing their data is CAN. Who is responsible for the groundwork? Are you part of the solution or part of the problem? The folks with the “TCM solution” got us to this point. It turns out they are the problem.
strong>5) The availability of jobs for acupuncturists is a pressing concern because students are now graduating with so much Title IV debt that it is impossible for many of them to start their own businesses, which means more and more graduates are never able to practice acupuncture at all. What do you think is the solution to this problem? And who is responsible for addressing it?
Student debt loads are disgusting, shameful, criminal. If you are not up to speed on this subject a simple google search under Harkin Hearings will catch you up. The new LAc curve has been flat or in decline for almost a decade. Money talks and bullshit walks. Would-be students are voting with their feet and going into other fields. What we can do as “leaders” with voices is pull together on behalf of the students and the profession and go after the openly fraudulent schools like California Union University that was shut down by the INS. A position statement by AAAOM, ACAOM, CAN and NGAOM that denounced visa scam practices would be a simple and bold beginning. If I may take the podium a moment…every school with a 50% failure of students who take the California Acu Licensing Exam or the NCCAPOM certification exam should be censured by the proposed coalition. Every school that sends less than half its graduate to sit for a licensing/certification exam should also be censured. These schools should be publicly identified and asked to defend their record. I often ask where is the outrage?