What Would POCA Tech Do without POCA? No, Seriously

The occasion for this blog post is yet another donation from POCA to POCA Tech of $10,000. And in addition to thanking all of our members, and particularly those who participated in the May Membership Drive (thank you! thank you! thank you!) I wanted to expand this post into a discussion. Whatever would POCA Tech do without POCA? Where would we be without our co-op?

Turns out there's a way to answer that question.

But first, did you know that cooperative development experts have disagreed about whether POCA is really a co-op?  Skeptics point out that unlike traditional co-ops, POCA doesn’t provide surplus revenue to its members in proportion to how much they use the co-op — in part because, as we all know, just like in community acupuncture, there is no surplus revenue. On the other hand, almost everything we do is characterized by the principle of mutual aid, which means cooperative as opposed to competitive factors operating in the development of society.

As Cris said recently, the only area in which POCA members actually compete with each other — not including the good-natured rivalry about how many treatments clinics provide — is around hiring qualified acupuncturists. There’s such a limited pool of candidates, and the economic stakes are so high, that the co-op motto “better together” becomes hard to remember during a tug of war over a promising punk employee.

So if we were indeed a co-op, what might we do about this problem?

A co-op might recall that Mondragon, arguably the most successful cooperative in history, started out with the formation of a technical college.

But, skeptical cooperative development experts might point out, making a technical college in Spain in the 1940s is very, very different from making an acupuncture school in America now! And if POCA can’t even give dividends to its members, how could it possibly create a school? Acupuncture schools are highly regulated, and meeting all the requirements to get accredited by ACAOM so that graduates can apply to sit for the NCCAOM should cost piles and piles of money.  There are so many structures an acupuncture school has to have in place, all requiring specialized knowledge to build and operate (this is so much clearer to us AFTER the Candidacy site visit than it was before) — how are we supposed to accomplish that without surplus revenue — a LOT of surplus revenue?

So how about this, skeptical experts — if POCA accomplished something that should be impossible under the rules of capitalism, and accomplished it through cooperation, would that prove that we’re a co-op?

Hold that thought for a minute, OK?

We’re attracting more prospective students these days and some of them really struggle with the concept that if they attend POCA Tech, they will owe the co-op three years of work in a POCA clinic. They just can’t wrap their minds around how inflexible we are on this point. This recalls other conversations over the years — for example, way back in 2012 I wrote: “…there is, out in cyberspace, some irritation that POCA is not trying to encourage every acupunk to express their unique vision and is not equally embracing of all approaches. Sometimes this amuses me and sometimes it makes me mad. When it makes me mad, it’s because POCA wouldn’t exist in the first place if I and a bunch of other people had thought first about what benefited us and our individual clinics most. Because all the movement-building stuff requires putting that aside, to a greater or lesser degree. And I don’t have any regrets about that. But I do get annoyed when people expect that POCA should prioritize individual punks doing whatever they want, however they feel like it—because a lot of those people have directly benefited from all the ways that the rest of us DIDN’T.”

Since we seem to be having this conversation yet again, I thought that this time, maybe some numbers would help. I thought, maybe we should re-calculate POCA Tech’s budget and see what would happen if POCA hadn’t been involved. So we did (thanks Carmen and Steve). We'll be posting a spreadsheet here, for serious numbers geeks.

Let’s start with fundraising. Between 9/13/12 (when we started fundraising for POCA Tech) and 6/10/16, POCA and its predecessor organization CAN have directly contributed $35,020.  Most of this revenue  has come from POCA patient memberships. Other fundraising that happened through POCA and its member clinics (the lego brick campaign, the Sustainers, etc) netted the school $156,462, for a grand total of $191,462.

That money would have evaporated very quickly if we had had to pay people to do the work required to set up the school, so we decided to estimate what THAT would have cost. We made a decision for this exercise to value everybody’s time at $40,000 for 40 hours a week,  or about $20/hr, which is the scale POCA Tech uses to pay its employees. Of course, the skills that were contributed would actually cost a lot more than that on the market: curriculum design, budget planning and oversight, information management, school administration, those don’t come cheap. From 9/13/12 through 6/10/16 we estimate that about 10 hardcore volunteers (fanatics?) donated over 18,000 hours of work, for a contribution of $365,962 worth of labor. This estimate does NOT include contributions of time by all the slightly less fanatical POCA members who nonetheless pitched in to write curriculum during a crunch in our state licensing process and ran the smaller fundraisers and designed promotional fliers — THAT list goes on and on, and we didn’t try to calculate the sum because it would just take too long. So consider that $365,962 is a low estimate of the true total labor donated by POCA members. Another way of looking at that figure is that we would have needed about two and a half full time paid positions, over the last three and three-quarters years, to accomplish what our volunteers did – which sounds about right to me.

Then there’s the library. Early in the process of working on POCA Tech, I couldn’t even think about the library because I felt so hopeless about it — ACAOM said we had to have one, and books are so expensive. Guess where we got our library? POCA members donated it or scavenged the bulk of it. Currently we’ve got 1185 volumes (1562 unique titles), plus DVDs and acupuncture models and bookshelves. If we had to buy it on the market, let’s call that another $100,000.

Then there are the Away Team faculty members who leave their clinics and come teach for beer, and Wade’s highly specialized IT skills, and office expenses, and textbooks like Dark Warrior (both volumes), and the Liberation Acupuncture essays, and Robert’s Japanese text Soba — all donated by POCA members or paid for by POCA itself, estimated at another $80,110 over the last four years.

The other thing I couldn’t stand to think about circa 2011 was the student clinic. Because of course we have to have one,  the whole point is to train people to be competent in clinic (also, ACAOM requires it). And any POCA member knows that a clinic means overhead. Lots of overhead, especially if the clinic’s as big as it needs to be in order for all of the students to be able to work in it. Not to mention that it has to be ADA accessible, with everything permitted, and nice enough to survive a site visit. And the clinic supervisors and the clinic coordinator need to get paid. Most schools charge their students to do their clinic internship, because they can’t count on enough patients to recoup all of the clinic’s expenses. POCA Tech doesn’t charge its students anything for clinic, because WCA donated its facilities (including supplies), its patient base, and all the staff. For awhile after WCA Lents burned, Sarah Baden of Acupuncture for Wellness donated her clinic facilities. So if you subtract POCA from the equation,  POCA Tech would have had to pay an additional $4318 a month since October 2015 when students started clinic. To set up the clinic space and get it ready for students — furniture, computers, utility hookups, first and last months’ rent in Portland these days — let’s call that an additional $20K. For a total of $54,500 clinic expenses contributed to POCA Tech by POCA. Eventually some of those costs will be recouped by patient fees for treatments, but if we're talking about starting up from scratch, we'd still have to have that money available upfront.

That comes to $792,034 of contributions to POCA Tech by POCA from 9/13/12 through 6/10/16. During that same period, students paid a total of $217,698 ($1550 application fees and miscellaneous, $216,148 in tuition).

Just 22% of the resources we needed to get the school to this point —  being able to have our Candidacy site visit — came from students. During the site visit, an ACAOM staff member told POCA Tech’s Advisory Board that he had no idea how our budget could possibly work, it was so tiny compared to every other school budget he’d seen. I wish we’d had these calculations for him to look at; it probably would have made more sense.

I asked Steve (SizzleK), POCA Tech's CFO, to figure out what all this would mean for POCA Tech's tuition, if we subtracted POCA and had to replace $792,000 worth of contributions. He said it would be hard to figure out exactly, but the only way to balance that budget would be to raise tuition. By a lot. Instead of $5800 a year, POCA Tech's tuition would be somewhere between $16,000 and $20,000. The other acupuncture-only programs out there (SIOM, Jung Tao, Middle Way) all seem to cost between $45,000 and $50,000 total – and all of them started up at least 10 years ago, or more, when it cost less to start an acupuncture school than it does now.

Currently we estimate that the total cost of POCA Tech's program is about $22,000; the cost of corequisites makes that a moving target.  If there were no POCA, the cost of our program would be about $50,000, more than twice what it is.

So there are two points I'd like to make about this.

First, prospective students of POCA Tech, looking at these numbers, I hope you understand why we're so picky about who attends our school and what they do with their education afterwards. The difference between what POCA Tech would cost without POCA and what it actually does cost represents a major obligation for anyone who attends. A lot of people looked beyond their own immediate self-interest to create something much bigger than they could have created alone; POCA is very, very serious about expecting POCA Tech students to reciprocate.

Second,  comrades, LOOK WHAT WE DID. Through our quirky little multi-stakeholder cooperative, we leveraged about $800,000 in order to create a new model for acupuncture education. Hey skeptical experts: WE'RE A CO-OP, HEAR US ROAR.

Author: lisafer

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Conference Keynote: Breaking the Ceiling

The theme for this conference is “Breaking Barriers”. You know, there are so many barriers to break in acupuncture that it was really hard to choose which ones to talk about for this speech. But since I’ve spent so much time talking about classism as a barrier, I thought it might be fun to shift gears a little and talk about numbers.


  1. This is amazing. Thanks for taking the time to break it all down! Funny, I actually opened the packet to review the direct wording of the “three years” requirement and I think it’s pretty darn lenient. Look, you’re/we’re training us to do a technical skill, and then asking that the individual that was just trained, actually do the profession of the technical skill! Makes sense to me. Way more sense than getting a Master’s Degree in the Art of Social Science and doing jack shit with it except trying to pay off the loans… 🙂 <3

  2. I know how much work it took to assemble these numbers, and just want to say how much I appreciate it, along with all the other work done by you and POCA members to make POCA Tech a reality. I think it’s good to remind us students (and prospective students) that PT isn’t just a cheap acupuncture education, that it’s part of a much bigger POCA effort.

    As we discuss and debate things like attendance and tardiness policies, it’s easy to think (by default) about PT like other colleges where we pay tuition and are consumers of the education, and this post is a great reminder that this is a totally different relationship.

    POCA is basically subsidizing every student’s education — to the tune of $10-15k per year — and if there are requirements for taking advantage of that patronage that are higher or more restrictive than a traditional consumer-based education, I think it’s justified. It’s like we’re each getting a big financial grant every year, and the co-op has specific ways they want that to be earned. As long as the expectations are clear up front, there isn’t a rational* basis for students to complain about the required commitment.

    Attending POCA Tech is a bargain (in both senses of the word) we all made with excitement and pride, and I think we all want to be a good investment.

    Thanks for the data, and for all the work that it’s tallying from the past few years!

    *I recognize that many people complain without there being a rational basis for it. Hopefully these numbers will make it clearer to those folks that there is a lot to be grateful for.

  3. Great post/analysis/breakdown.

    POCA DOES give back it’s members dividends.
    It is just not in monetary units!!!
    Just read through the past couple of blog posts!

  4. This warms my heart. I am SO proud to be a member of this organization and to be associated with so many amazing people. I stand in awe of everything that you all continue to accomplish. Hats off to POCA and POCATech!!

  5. Should this change the dialogue around the cost of acupuncture school in general? Of course schools are doing a huge disservice to their students if they aren’t clear on expected income, job opportunities, etc. And, no doubt, there are probably ways that schools could be less expensive without a cost to quality if ACAOM changed some of the requirements. I’m going to keep making noise about those things. And, perhaps I shouldn’t be so quick to put all non-POCA Tech schools in the “money-grubbing only out for themselves” box that I sometimes use.

  6. Elaine, that’s an interesting point. I would never have imagined saying this a few years ago, but there is a lot of expensive infrastructure associated with higher education in general — not just acupuncture education — that pushes costs upward. That said, there are so many efficiency hacks to be had, and more to be devised, that if the industry-wide goal really was to keep costs down of course costs could be kept down. So I’d say it’s structural, not personal.

  7. Sorry — can’t edit comments here — I meant to say, the change in dialogue I’d like to see would be something like: so, the DOE recommends keeping costs down for students as a way to meet the new Gainful Employment Regs, are we serious about doing that? If not, why not? And if we are, let’s get on that, collectively.

  8. I would just like to say, as a very new member to POCA, I am deeply grateful for this organization and all I have learned so far! I was about to jump in head first into a program charging those huge tuition costs, already having close to $45,000 in debt from my BA, telling myself, “yeah, it’ll all work out”. Something kept tugging on me to do my research. Then I found POCA. Because of the deeply honest insights that members are putting out there, this is one of the only places I’ve found that sticks to the integrity of honest information regarding post graduation realities. I really feel the need to say thank you for that.

    I cannot really understand why people are not grasping the idea that POCAtech expects their students to give back to what has been invested by so many. I think this article does a fantastic job of explaining it! I guess some paradigm shifts aren’t for everyone. Instead of starting the master’s program in oriental medicine that I was set on, I’ve signed up for some science classes at my local community college. I hope one day, I can perhaps be one of those people that experiences this wonderful collective and give back the way it’s designed!