The AAAOM Mess and My Take on the State of the Profession

In light of the recent article in Acupuncture Today detailing the implosion of the AAAOM   www.acupuncturetoday.com/mpacms/at/article.php?id=32868  I wanted to offer the last chapter of my book as part of the solution to this deep problem.   

Chapter 24

My Take on the State of the Profession

I wanted to offer my thoughts on where I see the A/OM profession in the U.S. at this point in time because I believe no book on practice building could be comprehensive without considering this. Like all else in this book, the following is my opinion based on my experiences over my more than 25 years in practice and my time as a student. Like it or not, there are important reasons why anyone getting started in this field should try to become familiar with the issues affecting the profession as a whole. I am not saying no one can become successful in practice without this understanding but having some knowledge of these profession-wide issues will help, especially if you follow my advice on how your involvement can greatly improve your odds of success. Please indulge me while I cover some ancient history, I promise this will lead to some useful advice.

I first became involved in “acu-politics” while still a student. One of my teachers helped develop the NCCA (before it became the NCCAOM). He explained to me the idea was to establish an exam that would meet professional certification/licensing standards so that it would be easier to get individual states to legalize acupuncturists by giving states the opportunity to use this exam instead of spending the time and money to develop their own entry-level exams. While I did not work on this myself, I followed the progress of this effort over the years and had a lot of respect for those who made it happen. It was a good idea and due to the years of hard work that was put into this effort, the rate at which states passed legislation legalizing acupuncturists was much faster than it would have been and this effort increased the credibility of our profession’s standards.

During the time I was in school, my state of California had already passed legislation establishing a committee to oversee our certification including developing and administering the state exam and approving schools. This being the case, the NCCA exam development was not followed too closely here. Most of the people in California involved in acu-politics were working on improving our status in this state and not so much in national acu-politics. While I tired to follow what was happening on the national stage, I first got involved in California acu-politics as a student when legislation was being promoted that would have mandated health insurance companies cover acupuncture. I attended meetings at an acupuncture school where those fighting for this held strategy sessions. This legislation did eventually pass but only after changing the wording in it from stating insurance companies would “provide” coverage to “offer” coverage. While a somewhat hollow victory, passing this legislation was a victory and some of those who got together to work on this decided it would be a waste to just disband so they formed a professional association—the California Acupuncture Association or CAA. 

I did not join the leadership of the CAA until a couple of years later and spent a few years chairing a committee and serving on their Executive Committee and their Board of Directors. At one point during this time, the leadership of the AAAOM asked to have a meeting with the CAA leadership. The CAA had grown quite quickly and had done a good job of building the infrastructure of a well functioning professional association. The AAAOM leadership asked for the meeting to plead with us to join forces with them as they were burning-out running from state to state trying to get legislation passed to legalize acupuncturists in as many states as possible. To my surprise, the leadership of the CAA declined the invitation and this, in my opinion, drove a wedge between national and California acu-politics that has still not been resolved today. As California has the largest number of A/OM practitioners (around 40% of the nation’s total), this lack of cooperation between those working on a national level and California has hindered our profession’s growth.

During the period just following the CAA’s decision to not team-up with the AAAOM, the California and national groups did their own thing with little communication between them. In addition to the NCCA (now the NCCAOM) and AAAOM, two other important “national” organizations were further developed; the body that sets curriculum standards and accredits A/OM schools (ACAOM) and the organization of representatives of those schools (CCAOM). The development of these organizations established the foundation of the A/OM profession’s primary infrastructure: A national professional association (AAAOM), an exam/certification system (NCCAOM), a school and curriculum accreditation body (ACAOM), and a coalition of school representatives (CCAOM).

These four bodies have all played important roles in advancing the A/OM profession in the U.S. and each of these organizations have an interest in seeing this growth continue and improve. But, while there are shared interests between these groups in the growth of the A/OM profession, there is—or at least should be—a natural check and balance dynamic also. What is best for one of these groups is not always best for another. This is how it should be. These groups need to keep their missions firmly in mind for them to meet those missions and to maintain their credibility. Looking for and working on common goals is of course a good thing, but there should occasionally be natural disagreements and cross-purposes between these groups. A healthy check and balance system is best for both the profession and the public.

Unfortunately, one of these four groups has for many years now been unhealthy and unable to serve its function in this check and balance system. This is our professional associations—both on the national level and, for the most part, at the state levels. This weakness has festered despite the best attempts and very hard work put-in by many who served in leaderships roles of these organizations. Something different must be done to improve the health of our professional associations. I believe there is a solution and the reason I am sharing this with you in a book on practice building is because those of you coming out of school can not only fix this problem but, in doing so, you can greatly increase your chances of building a successful practice. So, not only can you provide a service to the profession, you can do a great deal to help yourself at the same time.  

I mentioned in the first chapter that there have been different opinions over the years about what adjustments are needed to help the growth of the A/OM profession and improve the odds of success of those entering this field. A major theme of this book has been my view that the key to making a living offering acupuncture services is learning how to properly value those services within their respective markets. I also mentioned that my view on this was a recent refinement of my pervious view that the key to practice success was educating the public about acupuncture services and Licensed Acupuncturists. While my refined belief regarding this came from my realization that a good number of acupuncturists all over the world are struggling to make a living, I still believe quite strongly that, in the U.S. at this point in time, public education is badly needed to improve the odds of success in this field.

The history I offered above regarding the development of the A/OM profession’s primary infrastructure is a brief overview of the development of a profession that is new to the West. Many of the early supporters of A/OM in the U.S. were firmly convinced that acupuncture was destined to be accepted as a valuable healing resource and to their credit and the benefit of us all they set about building the infrastructure that would facilitate this acceptance. During those early years it was only natural that most of the emphasis was placed on promoting legislation to legalize acupuncturists while establishing our schools and exam systems. The focus during this stage then was essentially top-down—working with legislatures and other policy makers to establish those offering acupuncture services as a regulated profession meeting established standards.

The problem though was that once we had acupuncturists legal in most states and had our school accreditation and exam systems in place, our professional associations should have shifted their focus away from supporting those efforts and toward educating the public about acupuncture and acupuncturists. This shift in priorities never took place. We spent all these years fighting those who opposed us and building a brand new profession to service the public, but we never got around to educating the pubic about who we are and what we do! There were some modest, short term attempts at this, but nothing ever approaching the level of effort that went into building our infrastructure. It makes no sense at all that a group would go through the trouble to build a brand new profession and then do virtually nothing to announce to the public that we stand ready to serve them.

I have my theories why this shift in priorities never took place but those are not important now. What matters now is that we need those entering this field to take the lead in shifting those priorities. I keep using the term “public education” but  this could also be called “marketing.” Some people seem uncomfortable with the idea of marketing as that sounds like advertising and of questionable ethics. We need to get over this attitude. Educating the public about acupuncture‘s potential and the training of Licensed Acupuncturists is a public service and absolutely ethical. It will also do more to increase the number of those seeking our services than anything else we can do.

The public is very curious and interested in acupuncture but they are afraid to try to seek it out without knowing anything about the type of people who perform acupuncture or just how the treatment will take place. I explained in the chapter “Getting Them in Your Door” how the public’s lack of understanding about  Licensed Acupuncturists makes it imperative that we portray ourselves as caring, intelligent professionals. In that chapter, I offered ideas on how you can do that yourself in your own market but I mentioned that we also need to work on this within the profession as a whole. This is what needs to become the top priority of our professional associations and those entering this profession can make that happen.

Over the last 20 years, our various state and national associations have spent hundreds of thousands if not millions of dollars collectively on the top-down efforts especially lobbying for different legislation. This was needed in the past but now we need to raise money and human resources for public education/marketing. There are many ways we can reach-out to educate the public about who we are and what we do. It does not have to take huge sums of money to make great progress. There are many cost-effective to do this if you get creative, especially in this age of information technology.  

Doing so will not only help the A/OM profession to become better understood by the public but will also help us to secure our place as the acupuncturists with the greatest degree of training. Over the last 30 years many different health care professions have worked at getting acupuncture within their scope of practice. Medical Doctors can practice acupuncture in most states without undergoing any required training, Chiropractors can practice acupuncture in many states with 200 hours of training or even less and now Physical Therapists are needling ahshi points and calling it Dry Needling. Up until now, most of the leaders in the A/OM profession have tried to slow or stop this by stressing that these other professions should not be allowed to practice acupuncture with so little training but this approach has not been effective in most instances. Instead of relying on appealing to regulators to stop other health care professionals from practicing acupuncture, the A/OM profession should instead reach-out to the public and make our case there.

When we spend our meager resources trying to lobby regulators asking them to prevent other health care professionals from practicing acupuncture, we usually fail. But, even when we are successful, we still create bad blood between fellow health care professionals we could be working together with for the public good. If we were to shift our focus to educating the public about how our training standards in acupuncture are the most rigorous, we take the high road, don’t insult other health care professionals, and would always end up with the badly needed positive effect of educating the public about our profession.

This would help to both increase our profession’s patient base while protecting our future by solidifying ourselves as the top authorities in A/OM. Better to go on the offensive of building our standing with the public rather than trying to tear others down. 

What Is Needed Now

What you can do to make public education a priority is to join the AAAOM as a student member if you are still a student or a professional member if you are licensed and INSIST THAT THEY MAKE PUBLIC EDUCATION PRIORITY NUMBER ONE. Show your support for this by both your membership and by offering to pay extra for a public education fund. You should also do the same with your state association. There has been some 30,000 acupuncture licenses/certificate issued in the U.S. No one seems to know exactly how many are practicing right now but there are many thousands out there, many of them are struggling and we, as a profession, are doing NO MARKETING! There are also about 8,000 students enrolled in some 60 A/OM colleges at any given time. All we need is for a reasonable number of those involved with this profession to contribute a regular modest sum to mount a very effective public education/marketing campaign. There could be no better way to invest in the future growth of the profession and individual practices.

What I am talking about here is banding together to mount a collective public education/marketing campaign. There is tremendous strength in numbers and we have the numbers to make great things happen. If between the schools, practitioners and merchant suppliers we could get just 2,000 to contribute $100 a month, we could mount a $200,000 a month campaign! This could involve print media, radio, producing documentaries, and much more. There is so much that could be done that would lift this profession from the margins to being a household word. The interest is there. People are fascinated by acupuncture and they are sick and tired of having drugs shoved down their throats every time they go to a doctor. They just need to have their fear of the unknown eased by educating them about how they can find intelligent, caring professionals to provide acupuncture services in a manner that reflects the value of this service.

There would of course be many details to work out but having the financing and people to help facilitate this will give us the means to address those details. With the economy in the shape it is in right now, professional help can be had for less money than was the case in the past. We could afford to hire some experienced professional to help us especially considering that some of them have been helped by acupuncture and would be willing to help us in our goal of spreading the good news to the public. Have you seen the documentary 9000 Needles? It is a powerful movie about how A/OM helped turn an impending personal tragedy into a life of hope. This award winning movie is doing more to educate people about acupuncture than you could imagine. I have been working with that movie’s director (the brother of the movie’s subject) and he is open to making another documentary about A/OM that would even better educate the public. There are also many celebrities who have been helped by A/OM and we could get their help also. We just need to raise the funds to give us stable resources so we could mount a multi-year, multi-pronged campaign. If all we get is 1,000 contributing $50 a month, that is still $50,000 a month! We can do this.

All of you just entering practice or already in practice are going to have to spend thousands of dollars to begin and run your service business. I have tried to share with you my knowledge from years of my own successful practice to give you the best chance of becoming successful. As much as I believe the information I have shared will better your odds of making a success of your practice, I cannot stress enough how much better your odds will be if you band together with others like yourself and pool your resources into the type of campaign I describe above. 

I go through the trouble to tell you all this for your own good. My practice is very stable and I am in the final stretch toward my retirement  (at least that is what I tell my wife). I have nothing to gain from this campaign. You have everything to gain and so do the millions of people you can help educate about A/OM. I will do everything I can to help make this happen if you step-up. I have been waiting for this for many years now. Now that we have the infrastructure of our profession up and running, it is time to shift from the top-down approach of working with policymakers and put more emphasis on a bottoms-up approach of reaching-out directly to those we seek to service—the public. Our professional associations are the place to make this happen. They are the place where professionals gather to further the profession. We need fresh blood in these associations; people new to the profession who understand their best chance to earn a living is in private practice but also realize the power of collective marketing. The public is very interested in acupuncture but they know nothing about acupuncturists. You need to associate with your fellow professionals and educate the public. If you don’t do it, no one will.

I hope you have found my advice helpful and I will do all I can to help you from here. Please give serious thought to what I have proposed in this chapter. Undertaking a collective marketing campaign together with employing the advice I have offered in this book should give you a good chance to enjoy the blessing of earning a comfortable living while helping others as I have. Thanks for taking the time to digest my advice and good luck.

M a t t h e w  D . B a u e r,  L . A c .

Hi Matthew, 

Thanks for sharing this chapter. I also read the Acupuncture Today article and I’m wondering if you still think the AAAOM is an organization worth investing in. Can they be trusted to use our money effectively? Should acupuncturists in California also join the AAAOM as well as CSOMA? 

Also, I just finished reading your free sample chapters and ordered your book. Your writing seems very sensible and has me excited about acupuncture practice again, so thank you for that. I will be investigating this forum and posting elsewhere. 

Cheers,

Jonah

I hope you find my book useful and wish you the best. You asked a good question I have been thinking about since I posted this chapter from my book. In that chapter, I offer the advice that a professional association is the place where members of a profession associate and this type of association is very important to the growth of a new profession. I still believe the AOM profession needs successful professional associations but at this point in time, I don’t have confidence the AAAOM will survive its present difficulties so I can’t encourage someone to join right now. But my advice to join any of these associations came with the caveat that when doing so, you should insist that they make public education priority number one. Had enough people followed that advice, the AAAOM may have been saved and the whole AOM profession might be in a better position right now. Oh Well – that did not happen so where do we go from here?

For years I tried to work with our national professional associations to undertake a national public education campaign because I believed it was their job to do so and I thought it was the right way to reach members of this profession. I no longer feel this way about reaching members of the profession. None of these groups has been able to build enough members to be representative of our “profession” and, at the same time, social media has spawned the ability for professionals to associate without joining a traditional organization. Because of these two factors, I am now concentrating on trying to get support from enough members of the AOM profession but trying to reach them via social media rather than through professional associations. I will have more to report about my efforts to reach members of our profession with a plan to undertake a public education campaign. Please stay tuned. 

Matthew Bauer