“Federal options for debt forgiveness” is often given as a reason why we must seek Medicare inclusion. And the expense of our education is considered a big factor in why people aren’t entering the field. So why aren’t we laser-focused on what can be done to keep costs down and prevent that debt from accruing?
Wouldn’t that be in keeping with everything we know and teach our patients?
When our patients have a lifestyle that is leading to depletion, we don’t encourage them to keep expending Qi beyond their means, with a promise that if they fight hard enough somewhere down the line they’ll find a miracle cure.
The history of the Acupuncture profession in the US has included a steady increase in the required hours of training. With some state-level variations, required training to enter the profession has gone from 1000 hours prior to 1990 to a minimum 1905 hours as of 2011. If you are in a state that requires herbs it’s 2525.
I have never seen any evidence or even heard anyone arguing that the increase in required hours was a response to a revealed deficiency in the education or preparation of entry-level practitioners. That’s not to say there weren’t and aren’t deficiencies. (A lot can be done to improve education and training without adding hours.) But lots of those early program-grads, the ones that took those shorter programs, went on to have long and very successful careers.
The expansion in hours of education required seemed to be primarily…marketing. We want legitimacy and respect. “The establishment respects education.” They respect “Doctors.” We point to our hours of training with the expectation that “they” will defer to our expertise. And we are dismayed when they (still) don’t.
My best recollection is that my acupuncture-only training in the early 90’s cost about $26,000, or $55,411 in today’s dollars. Multiply by 160% to reflect the increase in hours (it’s a bit complicated because I was in a window when training was described in credit hours), and we get $88,658, which is about what a Master’s degree will set you back these days. Wouldn’t there be less debt with a $56,000 degree? And being mostly out of the workforce for a 2-3 year program, while not easy, is likely to result in less debt than being mostly out of the workforce for 4 years.
There’s another problem with our current degree situation. Prospective students have a much more complicated decision to make than we used to back in the day when it was an MAc or nothing. Now, if someone is considering a career in acupuncture, they need to consider where they might want to practice for their entire career. If they want to keep their options open they’ll be encouraged to get a more expensive OM degree. And if they are worried about building a practice they might feel pressured to go for the Doctorate – for the marketing value if nothing else. And they might learn that for some states there will be additional requirements (Florida and injection therapy training) or credentials (the CA exams). It’s easy to imagine potential students, stuck between choosing a degree they can almost afford but fear will limit them, or a degree that’s a real stretch but keeps their options open, giving up and choosing a different career.
Let’s focus on making acupuncture degrees more affordable. This would make our training more accessible and decrease the educational debt of our future practitioners. Isn’t that a better bet than focusing on a way to access debt forgiveness programs that might be available in the future if we manage to get the massive health-care bureaucracy to let us in?