by Bob Flaws

Several days ago I posted a blog supporting SIOM's proposal for an acupuncture only entry-level degree program. As a follow-up to that, I would like to state my opposition to a "first professional doctorate" (FPD) degree if such a degree was the only degree offered by our accredited schools and colleges. There have been discussions of creating the standards for just such a degree within the Accrediting Commission for Acupuncture & Oriental Medicine (ACAOM). Right now, a number of schools offer a post-graduate Doctor of Oriental Medicine (DOM) degree program which students who have graduated from MSAOM programs. Since those programs are completely optional, I support them, at least in principle. (I am somewhat critical of these programs' curricula and question whether they do create real doctors of Oriental medicine.) However, I am against requiring all entry-level students to take even longer, more expensive programs than currently exist. While I understand that physical therapists have recently adopted an FPD degree, I believe that such a requirement within our profession would lead to even higher rates of graduate failure and less access to acupuncture services for the majority of Americans.

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In previous blogs I have addressed some of the issues surrounding the jamming together of acupuncture and Chinese herbal medicine into a single entry-level program. I believe there is a definite difference in the knowledge and practical skills necessary to do acupuncture-moxibustion and Chinese herbal medicine. In Chinese colleges, there are separate degree tracks for these two modalities, and graduates only typically practice one or the other. Further, in China, acupuncture-moxibustion has always been seen as a secondary, adjunctive modality within the larger realm of Chinese medicine as a whole. Nevertheless, acupuncture-moxibustion is incredibly effective clinically, especially for the core group of disorders for which it is primarily used in China. Another unique characteristic of acu-moxibustion (in contradistinction to Chinese herbal medicine) is that a single practitioner can treat several patients at a time, whether in one large room or in several small treatment cubicles. In addition, it is my experience that competent acupuncturists can be trained in a single year (or less). Economically, students who graduate with less debt can afford to charge less money for their services. Since acu-moxa therapy allows for the treatment of multiple patients simultaneously, acu-moxa practitioners can charge less per patient but still make a very comfortable living by seeing more patients, making up in volume for less charge per patient visit.

Larry Gatti, writing for the Community Acupuncture Network (CAN) broad of directors on the CAN website says:

"Estimates show a high practitioner failure rate, with somewhere between 50%-80% of new graduates not practicing acupuncture five years after graduation- after having taken out student loans of $40,000 to $150,000 to fund their acupuncture education. While other healthcare professions, such as physical therapy, have changed their entry-level degree status to the doctorate level, there exist actual jobs for physical therapists upon graduation. Jobs also await occupational therapist, nursing, chiropractic and physician assistant graduates. The same is not true for acupuncture graduates, for whom entrepreneurship is the most likely option upon graduating."

Gatti goes on to say, "CAN maintains that the community acupuncture business model is both the best way to bring acupuncture to the masses with its $15-$40 sliding scale, as well as the most realistic way for graduates to make a living doing acupuncture." CAN Board President, Andy Wegman, has also stated:

"Acupuncture schools already encumber students with an unrealistic business model, not to mention significant student loan bills. What this adds up to is higher costs for patients, as students try to recoup their losses. The proposed doctoral degree would likely compound this problem, pushing acupuncture even further out of the reach of working and middle class people."

I very much agree with CAN's position on the FPD. Back in the 1980s, we made a mistake creating a single educational track for both acu-moxa therapy and Chinese herbal medicine. Now, rather than compounding that mistake by creating an even more time-consuming and expensive FPD, we should be offering more acupuncture only courses, similar to the one recently proposed by SIOM. Especially in these tough economic times (with their many long-term uncertainties), we should not be driving up the hours and, therefore, tuition required for professional entry. I believe we should be training more acupuncture technicians who can bring the benefits of acupuncture-moxibustion to a much broader segment of our society. We are not going to gain the financial rewards nor the social status we desire by simply awarding our graduates a doctoral degree. However, we can earn both of those two things if we really show a large part of our society that acu-moxa therapy is affordable and effective treatment.

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