An awful lot of conversations about acupuncture in the US, no matter where they start, end up eliciting some version of this plea. Whether it’s educational standards, dry needling by physical therapists, community acupuncture, or any heated debate about anything, the discussion isn’t complete until somebody says it. I’ve been thinking I should get a cowbell so I can ring it for my own entertainment whenever this happens. But since I don’t have a cowbell right now, instead, I’m going to say OK, you win, I’ll think about the profession.
Will Morris and Acupuncture Today want to help me out. “Professions define themselves in part by excluding others.” As far as I can tell, that’s the whole point of this article; to justify all our recent spasms of turf warfare. “Licensing is created in order to demarcate those who are prepared to provide service and prevent those who are not prepared from participating in the social and economic gains thereof.”
But what if, as all recent workforce data for acupuncture indicates, that there are virtually no social or economic gains associated with an acupuncture license? What if hardly anyone who is “prepared” to provide service is actually making a living by doing so? What if ALL our profession does effectively is to exclude others?
Granted, I’m a little touchy on this subject, because for the past ten years acupuncturists have been scolding me for – not necessarily in alphabetical order – demeaning/degrading/debasing/ denigrating/devaluing the profession. Which means, apparently, using the hell out of my license in my own neighborhood, and encouraging other acupuncturists to do the same. I guess I’m naive; I’ve been under the impression that the purpose of a profession is to provide a service to society and a livelihood to its members.
The acupuncture profession looks to me like a barbed wire fence surrounding a vacant lot. All our energy goes into patrolling the perimeter, because you know we gotta DEMARCATE. We’ve made sure you can’t get through the gate without paying a toll that will take decades of your life to repay. But once you get inside, there’s not a lot to do except congratulate yourself on how well demarcated you are – too well demarcated to do any actual work.
It’s remarkable how well-structured the process of educating and credentialing acupuncturists is, compared to the total and absolute lack of structure around employing acupuncturists. Doesn’t that seem odd to you? As John Weeks pointed out recently in another excellent article, we have “just enough credibility to get into debt but not enough to get out of it”. Acupuncturists typically blame our lack of credibility on the rest of the world – on all of the people who aren’t as impressed with our barbed-wire fence as we are. But we are the ones who built the fence, and who then didn’t build anything inside it. So I don’t get how it’s anyone else’s fault.
Won’t somebody please think of the profession is generally intended as a rallying cry, a call for all of us to – well, it’s often not clear what we’re supposed to do. Sometimes it’s clear what we’re not supposed to do: talk about the troubling cost-benefit ratio of our educations, write lewd haiku about our credentialing agencies, feel passionate about treating poor people. Sometimes what comes after won’t somebody please think of the profession is a lament about how apathetic and unmotivated acupuncturists are.
OK, as I promised, I’ve been thinking, and I have to tell you, the problem is a barbed wire fences around a vacant lot is just not that inspiring. Yeah, the barbed wire is elaborate and there’s a lot of it, but it’s basically hard to get people genuinely excited about exclusion. Most people are better and saner than that; if you want to inspire them to action, you need to offer something constructive and practical. Also, you shouldn’t really be surprised that most acupuncturists are wandering around their vacant lot in a daze – or just trying to quietly slip out. It’s a shock to have spent so much time listening to lofty rhetoric about the profession only to discover that, for all intents and purposes in the real world, all you’ve ended up with is an expensive hobby.
We’re not going to have a thriving profession until we take our attention away from excluding people and put our attention on treating people. We’re not going to have credibility until we have jobs. We’re not going to have jobs until we figure out how to make ourselves useful. And don’t tell me it’s not that simple unless you happen to employ more acupuncturists – for the purpose of actually doing acupuncture – than I do. If you employ more than 10 L.Acs, you can lecture me about the complexities of job creation. Otherwise, please take my word for it. Job creation is not rocket science. It involves simple yet demanding tasks like identifying how people want to use acupuncture in the real world (as opposed to our dreams) and then translating their desires into a funding base.
Granted, it’s easier to build a barbed-wire fence than it is, say, to tend a garden; it’s easier to keep people out than it is to keep them busy. Turf warfare is a lazy substitute for the hard, real work of building a profession that has a meaningful role in society. Yeah, I’d like to ring a cowbell for every won’t somebody please think of the profession that I hear, because it’s so predictable and so pointless, but I’d also like to say, why don’t you do something real? It’s not a coincidence that my business employs 10 L.Acs and that I think turf warfare is stupid. There’s a causative relationship there. Job creation isn’t complicated but it does require focus and a lot of energy. We don’t have such an abundance of resources that we can both keep people out and keep people busy.
Community acupuncture is growing fast, to the consternation of those who think we’re bad for the profession. You want to know why? We’ve got something other than barbed wire fences to inspire and motivate us. While the acupuncturists who support turf warfare are grumbling about dry needling, we who don’t support it have rolled up our sleeves and are trying to construct some economic infrastructure for ourselves. We’re building something, and it’s amazing how energizing that is.
Until you can get acupuncturists collectively focused on some creative, practical, constructive action, you can’t in good conscience ask them to think about the profession. It’s just a rhetorical question. Because right now, there’s just not that much to think about.