Monthly Archives: November 2015

How we Grow – The Acupuncture Profession in 2015

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One Physician per 371 non-institutionalized civilians was the US average in 2012.

One Acupuncturist per 20,000 non-institutionalized civilians was the US average in 2014.

NCCAOM’s 2014 Annual Report is an important read for anyone who cares about Acupuncture in the US. From it we learn:

  • Applications for certifications dropped from 1744 in 2013 to 1494 in 2014.
  • The number of new certifications dropped from 1144 in 2013 to 972 in 2014.
  • 532 of those new certifications were in Oriental Medicine. Another 16 were for Chinese Herbology (likely existing LAcs choosing or being required to add the Herb certification).

I don’t know how many practitioners are leaving the profession, but many of my peers who were licensed 20+ years ago are stepping back from active practice.

Several current initiatives, including HR 3849 and state-level efforts to mandate insurance coverage of acupuncture would increase demand for acupuncture. (There are 49,435,610 Medicare beneficiaries in the US and 5.5 million Gulf War Vets.) If fully trained Acupuncturists aren’t able to meet the demand, who will provide those services?

At this rate, how long will it take to grow the profession to even one Acupuncturist per 2000 people?

Shouldn’t we focus on that?

I’m baffled. We’ve sued, signed petitions, and marched in the street, all to try to stop the “greatest threat to our profession” – other professions wanting to use the acupuncture needle.

But there’s been silence, or even approval, when Florida (with one DOM for every 17,760 people) changed their regulations in 2014 to require all 4 NCCAOM exams for licensure. Ditto in NJ where new practitioners will need the NCCAOM herb exam to use herbs in their practice. (How many citizens had been harmed by use of herbs by practitioners without the herbal credential? Was regulation needed?) In Nevada (approximately 1 Acupuncturist for every 47,000 citizens) the Board of Oriental Medicine is moving to require a DAOM of all licensees. Meanwhile, many insurance plans are limiting their provider pool to those with active NCCAOM certification, even in states that don’t require that credential. (After all, the vision of the NCCAOM is that “Acupuncture and Oriental medicine provided by NCCAOM credentialed practitioners [emphasis mine] will be integral to healthcare….”)

If we want the public to obtain services from well-trained Acupuncturists we need to make sure providers are available. One thousand new practitioners a year and growing self-inflicted restrictions on where and how we can practice aren’t going to do it.

The greatest threat to our future is an Acupuncture workforce insufficient to meet demand or effectively advocate for ourselves. Allowing or supporting credential creep, educational bloat, and practice restrictions are sowing the seeds of our demise.

Can we please focus on growing our profession?

 

Demographic Information From:

Acupuncture Today Density Map

Physician Data

Population Data

Medicare Data

Veteran Data

November ’15 Acupuncture News Update, Chapter 1

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It isn’t easy keeping up with Acupuncture News. Now and then a “clear the decks” post (or two, or three) is needed. Here goes:

HR 3849: Representative Judy Chu (CA) introduced “The Heroes and Seniors Act ” which would add acupuncturist services to Medicare and would increase the availability of acupuncture to members of the military and Veterans. The bill has a long list of endorsing organizations. Supporters should share their analysis of what would happen in the twenty states with fewer than 100 LAcs*. In a business with competitors, creating demand for a service without the ability to provide it is a bad move.  I’d be more worried if I didn’t agree with govtrack.us – there is a 0% chance of the bill being enacted.

Dry Needling: In late September the North Carolina Acupuncture Licensing Board filed a complaint in the General Court of Justice against the North Carolina Board of Physical Therapy Examiners, asking the court, among other things, to declare dry needling the unlawful practice of acupuncture. In early October the North Carolina Board of Physical Therapy filed their counter suit in US District Court seeking triple damages for the NCALB’s illegal and anticompetitive acts. Not surprisingly the same LAcs who cheered on the NCALB suit were outraged that the NCPTE would return fire. Given the SCOTUS ruling from this past year I believe the acupuncture community is in a risky place. If the PT’s prevail it will be a game changer nationwide. Did the AG’s office (which had previously ruled that Dry Needling could be within PT scope) advise the NCALB on their complaint? Are all North Carolina Licensees picking up the legal tab for what looks like outside counsel?

In other news the acupuncture community has been touting the revised AAMA Policy on Dry Needling. The Middle Eastern saying “The enemy of my enemy is my friend” comes to mind. It’s a strategy that can win battles, and can create more of them. I don’t think of Medical Acupuncturists or PT’s as enemies. I do remember our insistence that the 200 (or 300?) hour training of the MD Acupuncturists is insufficient. And I wonder whether the PT’s could increase their training to 200 (or 300?) hours and then argue that all of acupuncture is open to them.

Nevada: The minutes of the November 5th Nevada Board of Oriental Medicine haven’t yet been posted, but I understand from attendees that the Board is planning to hire legal counsel, the cost of which will fall on existing licensees. Why does the Board need to hire legal counsel? Because they continue to pursue actions that go against existing code and legislation, rejecting the counsel of the Attorney General’s office. The news from Nevada is a reminder that having an independent acupuncture board isn’t necessarily great for the public or the profession.

Looks like there will be at least one more “Clear the Decks” post. Coming soon  – news about: acupuncture and insurance, NCCAOM’s annual report and more, ACAOM’s hot news, regulation in the District of Columbia, Lamar Odom and the future of herbal regulation, and what’s happening in the AAAOM.

 

* I use LAc to refer to all professionals holding the proper government license to provide primarily acupuncture and TCM services. Having no clear way to refer to, define, or describe this group of individuals is representative of our challenges!