Survey Confusion

[Guest guest]

Todd and all,

 

> I am not so sure about that. I think most people in this field are better

> at TCM than they are at marketing and business management, myself

> included.

 

I have no reason to disbelieve that! If I did, I wouldn't have concluded that

the methodology I suggested was valid. The post you quote suggested that a

survival-in-practice survey would label as " successful " someone who was

better at business than at practice. I was admitting the limitations of the

idea I proposed and asserting that it was not so critical a limitation as to

make the method infeasible.

 

> The most financially successful practitioners often excel at the

> " business " of patient care. Anecdotally, I don't see the correlation

> between rigorous education and financial success.

 

I believe the issue is more " appropriate education " than simply rigorous

education and that rigor is not only scholarship. Clinical education can and

should be rigorous . The claim of my post was that students are people who

want careers in CM, and without a way to take the pulse of those careers, we

lack information to make any judgment. We need feedback. Saying

education is the way it should be because a people pass their exams, is like

saying a patient has been cured because we've finished the steps of a

treatment. We need to know if they got what they came for.

 

And from Rory:

> I'm not so sure about it either, but neither am I sure that financial

> success is a good measure of a successful practice -- surely successful

> treatment would be a better measure, even if it's on a small scale, and

> for low, or no, fee.

 

Hard to disagree with that! However, the idea is still controversial and once

you start looking at the costs, and how to get the funding, the value of

survival assessment looks even greater because it is something we can afford

to do with the money we have. Any attempt to measure efficacy is more

expensive, more difficult to execute and muchless likely to get done. To

show efficacy in any meaningful way we would have to proceed outcome

study by outcome study to build a solid case. Otherwise, the conclusions

would be meaningless as a measure of education.

 

> It would be

> interesting to see if a valid survey supported my position or yours.

 

My position is that it is a problem that we don't know. I don't think anyone

knows with enough certainty to make much in the way of claims.

 

I heard of a survey that asked whether people did 10-to-40 hours per week

of practice and concluded that 60% of all graduates were successful based

on that criteria. I have not seen the detail, I'm re-telling an oral report

(gossip by any other name), so I can't be judgmental. However, IF THIS IS

THE CASE -- IF!!! -- I can't imagine that it is a meaningful study because

the range of 10 to 40 is too broad and the appropriate gauges of success for

education is whether the students achieve the life they sought in

undertaking that education and whether those students have made a

positive impact in society. A meaningful survey needs to address what our

graduates do well or poorly because we are looking for ways to do a better

job of fulfilling the promises of education.

 

I do admit that I think that the 60% figure is suspect. If 60% of all

graduates were " successful " we'd be seeing much greater growth rates in

supply sales, much stronger self-financing of practitioner associations and

alumnus groups, greater investment levels, etc.

 

Bob

 

 

 

bob Paradigm Publications

www.paradigm-pubs.com 44 Linden Street

Robert L. Felt Brookline MA 02445

617-738-4664

 

 

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[Guest guest]

Bob,

 

, " Robert L. Felt " <bob@p...>

wrote:

 

Saying

> education is the way it should be because a people pass their

exams, is like

> saying a patient has been cured because we've finished the

steps of a

> treatment.

 

I don't think anyone said that, least of all myself or Rory

 

We need to know if they got what they came for.

 

If what you mean is that they should also be trained more

thoroughly in practice management or that the schools should

devote more resources to career placement, I agree. So while I

agree education has been inadequate, I still think this is a

separate issue from financial success. While it would be

illuminating to know the answer to this question, the fact

remains that many of the least " educated " practitioners are the

most financially successful.

 

I have to add that it is quite disappointing that proficiency training

in medical chinese is not required for accreditation of doctoral

programs. congratulations to those programs that plan to

require such. We have to live with the fact that the profession as

a whole has already institutionalized master's level training

without chinese language requirements. Nothing will ever

change that. the standard for changing educational

requirements hinges on the issue of public safety most of the

time. because of our excellent safety record, it would be hard to

make any changes at the master's level in the future (except

perhaps absorbing it into the doctorate, but even this has strong

opposition). So if we opt for the highest level of training to be

represented by those who are still helpless to access 99% of

the material necessary for scholarship and research, who is

going to do this.

 

I know we have debated the importance of chinese language for

successful practice. But are we in agreement that it makes

sense for the doctoral level, even if not for the master's. I don't

think we ever had that clarified.

 

> I heard of a survey that asked whether people did 10-to-40

hours per week

> of practice and concluded that 60% of all graduates were

successful based

> on that criteria.

 

I talked to a recent grad (2 years out) the other day. She

averages 25 patients per week, which is pretty good compared

to many of her classmates, who see about 10. However, she

sees each patient about 3X/week. so her increased load is

largely due to agressively insisting that multiple treatments are

necessary. She gets good results and now is building some

word of mouth, but I know plenty of " successful " practitioners like

her who are still stuck at 35 patients per week or less after 5

years. In addition, this women charges her patients below

market rate to get them in 3X/week.

 

So let's see. After her split with the clinic owners and/or

expenses, this woman nets about $25-30 per patient before

taxes. That's 37,500 a year. If she was seeing 35 patients, it

would be 52,500. Many people tell me that's their limit (35-40).

In order to do better than this, you need to own your office, rent to

others, make pharmacy profit and increase patient volume. but if

you work in someone else's office, unless you can charge

outrageously high fees (beverly hills or some such place), the

existence is not very posh. consider that for 10 years, 12,000 a

year will go to paying off student student loans. After taxes,

you've got 20,000 to actually spend (if your making 37,500). So

that's like $1,666/month in disposable income. Rent in san

diego is at least $800 a month for a decent apartment. you see

where I am going with this?

 

It really is all about business savvy. I suppose students should

be told at admission that in addition to 80,000 in student loans,

figure an equal amount to establish your own practice with staff,

pharmacy, etc. and pay all the bills till you make a profit.

 

Despite all the real educational shortcomings at the master's

level, surveys do report a high level of patient satisfaction. I work

20 hours per week in the PCOM teaching clinic and it is

unacceptable to me to not achieve results with the patients. I

can honestly say that for the bulk of the patients who seek out

acupuncture (most of whom are actually there for straightforward

musculoskeletal complaints, stress and hormonal imbalances),

training is currently far more than adequate. It is in the treatment

of complex chronic internal illness that shortcomings are more

evident. However, these are by far the minority of cases (much

to my chagrin). So I think students are well trained to treat what

they typically see. So I don't think its lack of knowledge. In fact, I

think clinical success is quite good for pain and self-limited

complaints (like PMS), even during internship.

 

I want education to improve so TCM can make forays into the

treatment of serious chronic illness. I think the schools do a

decent job creating entry level clinicians. the question is how

much responsibility should they take for the financial success of

their students. Well, it makes sense to care a lot, unless we

want this profession to be tuition driven till it collapses. Higher

medical education is endowment driven. endowments are

made by successful, happy, wealthy alumni who want to give

something back.

 

[Guest guest]

, " " <@i...> wrote:

> I know we have debated the importance of chinese language for

> successful practice. But are we in agreement that it makes

> sense for the doctoral level, even if not for the master's. I

don't think we ever had that clarified.

 

:

 

Could each teacher post their doctorate level syllabus, so we know

what we're discussing in detail?

 

 

Jim Ramholz

[Guest guest]

we don't have an approved program at PCOM yet, but it will

include language requirements.

 

 

, " James Ramholz " <

jramholz> wrote:

 

:

>

> Could each teacher post their doctorate level syllabus, so we

know

> what we're discussing in detail?

>

>

> Jim Ramholz