entry DAOM

[Guest guest]

Dave,

 

, acuman1@a... wrote:

> This is the same saw I heard when we moved from diploma to Master's entry

> level in the late 80's.

 

Be that as it may, we have already reached past the upper limit of return

on investment for an acupuncture education. Many students already

graduate with barely manageable $80,000 debts. Add another $40,000 for

another 2 years, assuming that creditors will ever loan that much to an

acupuncture student. That extra debt would result in a standard of living

that is unacceptable unless you believe that conferring the title of

doctor would instantly result in enough extra income to offset the

increased debt. I do not.

 

I believe the anecdotal evidence suggests that the current typical

educational debt is already tas high as it can get and still allow people

to make an adequate living. While our services may be technically

undervalued, especially by insurance companies, they are still already

more expensive than most patients can afford. so colluding on price hikes

will not work to increase income. the market will not bear it. the only

way I can imagine an entry level doctorate that does not dramatically

decrease the number of new students entering the field is some source of

funding that lowers the cost of the education to something more reflective

of its typical return. Endowments, state funded schools, donations, etc.

The tuition driven mom and pop shop model might collapse under the weight

of an entry level doctorate.

 

 

Chinese Herbs

 

 

" Great spirits have always found violent opposition from mediocre

minds " -- Albert Einstein

[Guest guest]

While our services may be technically undervalued, especially by insurance companies, they are still already more expensive than most patients can afford. so colluding on price hikes will not work to increase income. the market will not bear it. the only way I can imagine an entry level doctorate that does not dramatically decrease the number of new students entering the field is some source of funding that lowers the cost of the education to something more reflective of its typical return

>>>Thre question is would it mainstream OM. If it does the money would be moot. People would have jobs and make money

alon

[Guest guest]

> The tuition driven mom and pop shop model might collapse under the

weight of an entry level doctorate.

 

 

 

I agree that the DAOM is economically a no-start proposal for most

acupuncturists. I just don't see people willing to spend the extra

time and money going back to school for a credential and training with

doubtful ROI.

 

That being said, I also think the tuition-driven mom and pop shop

model of acupuncture and CM education should collapse. I believe it is

at least partly responsible for the economic plight of many

acupuncturists. IMO, one reason people open ever more, dubious quality

mom and pop schools is because they aren't making a decent living

solely in practice.

 

As for people not being able to make a decent living, it is my

experience that they could if they were willing to 1) take their

services to where they're needed (as opposed to clustering in a few

hip, New Age enclaves such as Santa Fe, Portland, Boulder, and San

Diego), 2) adopt a mature business plan, 3) market themselves to

people with the kind of income they themselves would like to make,

4) sell other collateral goods and services (up-selling and

cross-selling), and 5) be willing to risk the added investment of

working out of a commercial space with 6) at least one employee

(receptionist minimum). For free articles on all these

requirements/factors for economic success, see

www.100Kacupuncture.com.

 

I just came back from teaching/vacation in Playa del Carmen, Mexico.

Two of my fellow " bare-footers in paradise " were a couple of

acupuncturists only two years out of school who are making 100K in

Portland, OR where I know many acupuncturists with more time in

practice are living a life of genteel poverty. Why have these two made

such a good start so quick out of the box? They have manifested all

the above criteria (except for staying in Portland), they work hard,

and are willing to do whatever it takes: radio shows, tv ads,

public-speaking, writing columns, etc. It can be done, but it can't be

done the way most/many acupuncturists attempt to do it.

 

I know another two recently graduated acupuncturists living in L.A.,

one who is making it (and was a barefooter in paradise) and one who is

not (and stayed behind in smoggy L.A.). The one who is making it has

bitten the bullet and manifested the above factors for success. Her

boyfriend, who is trying to practice out of his apartment, is not

making it. He's afraid/unwilling to take the leap/risk.

 

Yet another barefooter in parasise from NYC is making it after a

number of years of not. He finally realized that he needed to go to

work in a PI clinic (where he makes more than 100K per annum). He

makes enough that he was able to spend a week with us in Playa and

then another week in Cozumel diving (expensive hobby). He explained

that working in this sort of PI clinic was not optimal (to say the

least), but it has allowed him (after a couple of years of working for

less than altruistic MDs) to open his own clinic in a commercial

space. While he's still transitioning from clinic employee to private

practice, he rents space to other acupuncturists who prescribe from

his bulk herb pharmacy. I feel confident this " acupuncturist " will be

making well more than 100K per year from private practice alone in

another two years as long as he keeps moving in the direction he has

committed himself to, along with all the attendant risks, tasks, and

obligations.

 

Bottom line, I do not believe the low income earned by most/many

acupuncturists has anything to do with our title. I believe many

people just don't know how and/or are unwilling to do what it takes to

run a financially successful practice. It seems to me that too many of

us look to others to do something to increase our income for us by

some sort of fiat (grant us some other title, grant us access to more

third party payors, etc.). However, I believe the money is there to be

made given our current titles and current access to the health care

marketplace. If people cannot afford our fees, we're marketing to the

wrong people. I know financially successful acupuncturists in Boulder

of all places who only have to work three days per week. That means

that, if they so wanted, they could work another day or two per week

either pro bono or for reduced fees for those with lower incomes. In

other words, we can earn a decent living and provide health care to

the less fortunate if we first create and implement a financially

successful business plan.

 

Bob

[Guest guest]

Have I missed something here? I thought that the DAOM (until they

petition to through out the 'O'...) would be the entry level program? I

did a 4-year MTCM program, which, in theory, should cost about the same

as a 4 year DAOM program. If DAOM becomes the entry level program, then

the costs will be rougly the same as they are now. For some of us

though, it's going to cost a lot more, since we've already taken out our

$80k in loans, and to change a few letters at the end of our name

probably isn't going to make a lot of economic sense.

 

Geoff

 

ps - my apologies if this went twice - my e-mail provider has had some

LI stagnation..

 

> __________

>

> Message: 8

> Fri, 30 May 2003 14:56:59 -0000

> " Bob Flaws " <pemachophel2001

> Re: entry DAOM

>

> > The tuition driven mom and pop shop model might collapse under the

> weight of an entry level doctorate.

>

>

>

> I agree that the DAOM is economically a no-start proposal for most

> acupuncturists. I just don't see people willing to spend the extra

> time and money going back to school for a credential and

> training with

> doubtful ROI.

>

> That being said, I also think the tuition-driven mom and pop shop

> model of acupuncture and CM education should collapse. I

> believe it is

> at least partly responsible for the economic plight of many

> acupuncturists. IMO, one reason people open ever more,

> dubious quality

> mom and pop schools is because they aren't making a decent living

> solely in practice.

>

> As for people not being able to make a decent living, it is my

> experience that they could if they were willing to 1) take their

> services to where they're needed (as opposed to clustering in a few

> hip, New Age enclaves such as Santa Fe, Portland, Boulder, and San

> Diego), 2) adopt a mature business plan, 3) market themselves to

> people with the kind of income they themselves would like to make,

> 4) sell other collateral goods and services (up-selling and

> cross-selling), and 5) be willing to risk the added investment of

> working out of a commercial space with 6) at least one employee

> (receptionist minimum). For free articles on all these

> requirements/factors for economic success, see

[Guest guest]

, " Geoffrey Hudson " <

list@a...> wrote:

>

>

> Have I missed something here? I thought that the DAOM (until they

> petition to through out the 'O'...) would be the entry level program? I

> did a 4-year MTCM program, which, in theory, should cost about the same

> as a 4 year DAOM program.

 

current masters programs are mandated to be around 2500 hours by ACAOM;

DAOM will be 4000 including those acquired at the masters (1200 min post

masters). many schools already do over 3000, but many do the minimum.

more hours, more cost. PCOM will top out at 4500 for both masters and

DAOM. PCOM does not support an entry level DAOM at this time, BTW.

 

[Guest guest]

, " Bob Flaws " wrote:

> As for people not being able to make a decent living, it is my

> experience that they could if they were willing to 1) take their

> services to where they're needed (as opposed to clustering in a

few

> hip, New Age enclaves such as Santa Fe, Portland, Boulder, and San

> Diego), 2) adopt a mature business plan, 3) market themselves to

> people with the kind of income they themselves would like to make,

> 4) sell other collateral goods and services (up-selling and

> cross-selling), and 5) be willing to risk the added investment of

> working out of a commercial space with 6) at least one employee

> (receptionist minimum). For free articles on all these

> requirements/factors for economic success, see

> www.100Kacupuncture.com. >>>

 

 

Bob:

 

While there is nothing to really disagree with in your statements,

you still ignore our situation: there are few, if any, jobs in

institutionalized medicine for real acupuncturists upon graduation;

they don't have equal access to all the insurance providers; they

cannot get hospital privileges; many must be supervised by MDs who

have no training in the field; and herbs are not in the scope of

their practice.

 

 

Jim

[Guest guest]

> While there is nothing to really disagree with in your statements,

> you still ignore our situation: there are few, if any, jobs in

> institutionalized medicine for real acupuncturists upon graduation;

 

Jim,

 

Agreed. I wasn't intending to imply that I believe politics are

irrelevant. As you know, I once chaired the legislative committee of

the Acupuncture Assoc. of CO. I just don't believe they are our main

economic salvation. I think too many of us blame others for our own

lack of financial success.

 

Also, the situation is different in different states and even within

different cities in different states. Since this is America, one has

two choices. One, they can move to a state where the laws are more

amenable, or two, they can get politically active and changes the laws

in the place they are in. In New York, you can work in various

MD-owned PI clinics, and Mercy College has placed its students in at

least three hospitals in the NY metro area and other hospitals have

made inquiries. Here in Longmont, CO there are acupuncturists working

in the hospital there. I have worked in an Evergreen MD's office, a

Brighton DC's office, an MD-owned pain clinic which operated out of

St. Luke's Hospital in Denver, and at Denver General Hospital. It can

be done.

 

> they don't have equal access to all the insurance providers;

 

Agreed, no equal access. But that doesn't mean no access. More and

more insurance companies are paying for acupuncture. The question is

do you really want to have that kind of practice. One can be

financially successful with a cash only practice. It all depends on

how you do it.

 

they cannot get hospital privileges;

 

Maybe, maybe not. I suggest you or anyone else interested in this to

read the free article on this issue written by David Kailin posted on

www.bluepoppy.com and/or at www.100Kacupuncture.com. Have you tried to

get hopsital priviledges and been rejected?

 

many must be supervised by MDs who have no training in the field;

 

Many? How many out of the entire 15,000 licensed professional

acupuncturists in the U.S.? My impression is that this requirement is

only in a couple/few states. I agree that acupuncturists in those

states need to get more active to change that.

 

and herbs are not in the scope of their practice.

 

How many states do not allow acupuncturists to prescribe Chinese

medicinals? I have no idea on this one. Do you have the figures? In

any case, if only 10% of acupuncturists sit for the NCCAOM herb exam,

maybe this is not such a bad thing.

 

Bob

[Guest guest]

I think it is safe to say that acupuncture/Chinese medicine is, for most people, a self-employment situation. With that said, I think the pros/cons of the situation are not communicated at most schools. Most students realize this fact after graduating. One really has to learn the skills to promote their practice in order for the practice to grow. Whether one likes it or not, one of the major skills required to get people in the door is selling. Unfortunately, there are many pitfalls and some of these you can prepare for and others you have to learn by experience. I think many people, after being in practice for a year or two, might be more than willing to except a $35k a year salary if all they did was have to come in a treat patients. There is a lot of personal growth that is required to sustain a successful practice.

 

On a side note, most of the income in private practice comes from acupuncture. I've even considered increasing my regular tx price and 'throwing' in the herbs. It's just another approach. In the long run, getting results is still priority #1. If you don't have that, it is hard to sustain a practice. Just my 2 cents.

 

Eric Popp, L.Ac., Dipl. C.H.

Bob Flaws <pemachophel2001 wrote:

> While there is nothing to really disagree with in your statements, > you still ignore our situation: there are few, if any, jobs in > institutionalized medicine for real acupuncturists upon graduation;Jim,Agreed. I wasn't intending to imply that I believe politics are irrelevant. As you know, I once chaired the legislative committee of the Acupuncture Assoc. of CO. I just don't believe they are our main economic salvation. I think too many of us blame others for our own lack of financial success. Also, the situation is different in different states and even within different cities in different states. Since this is America, one has two choices. One, they can move to a state where the laws are more amenable, or two, they can get politically active and changes the laws in the place they are in. In New York, you can work in various MD-owned PI clinics, and Mercy College has placed its students in at least three hospitals in the NY metro area and other hospitals have made inquiries. Here in Longmont, CO there are acupuncturists working in the hospital there. I have worked in an Evergreen MD's office, a Brighton DC's office, an MD-owned pain clinic which operated out of St. Luke's Hospital in Denver, and at Denver General Hospital. It can be done. > they don't have equal access to all the insurance providers; Agreed, no equal access. But that doesn't mean no access. More and more insurance companies are paying for acupuncture. The question is do you really want to have that kind of practice. One can be financially successful with a cash only practice. It all depends on how you do it.they cannot get hospital privileges; Maybe, maybe not. I suggest you or anyone else interested in this to read the free article on this issue written by David Kailin posted on www.bluepoppy.com and/or at www.100Kacupuncture.com. Have you tried to get hopsital priviledges and been rejected?many must be supervised by MDs who have no training in the field; Many? How many out of the entire 15,000 licensed professional acupuncturists in the U.S.? My impression is that this requirement is only in a couple/few states. I agree that acupuncturists in those states need to get more active to change that. and herbs are not in the scope of their practice.How many states do not allow acupuncturists to prescribe Chinese medicinals? I have no idea on this one. Do you have the figures? In any case, if only 10% of acupuncturists sit for the NCCAOM herb exam, maybe this is not such a bad thing. BobChinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

[Guest guest]

Though I have not viewed all the messages concerning this subject 'DAOM', I

do agree with Bob Flaws about questioning whether acupuncturists would want

a primarily insurance reimbursement system for our services, I most

emphatically do not. I relish having control over my schedule and time in my

office. I am concerned that in our effort to gain 'mainstreaming and

legitmacy' we will end up exactly where MDs and possibly DCs are now, with

having to treat many, many patients in order to make a decent living. I

enjoy having the luxery of spending most of an hour with my patients as I am

able to keep an eye on their progress, pulse, etc and often I use this time

to get more, in depth, information about my patients I might not have gotten

had I been running from room to room. Many would not wish to practice in

this way, but I do. If we train our patients to only seek treatment from us

with insurance coverage and/or a very small co-pay, I guess we deserve what

we get. Jocelyn Joy

 

 

 

Jocelyn Joy, L.Ac., DOM

Inner Spring Center for Health

3361 4th Avenue

San Diego, CA 92103

619-322-4492

 

_______________

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[Guest guest]

I'm wondering, do you take primary insurance reimbursement? I do, and I

don't have an insurance company dictating to me what my schedule is. If

I decide that I want to see a whole lot of patients per hour, then

that's my choice. I choose to see a patient an hour, and I do just

fine. I find that practitioners that have been in practice for a long

time usually are the ones who say 'just do a cash-only practice' because

they get frustrated in dealing with insurance companies. I think that

acupuncturists have climed up the ladder a ways, and it must not be as

bad as it was in the past... now that the insurance companies have seen

that we don't bill like chiropractors. I've been in private practice

for about 3 years, and there's no way I could have made a decent living

with a cash only practice. When the stock market and economy in Seattle

started it's downturn, my cash patients dried up. I still have my

insurance patients though. I think for most young practitioners, they

need to take insurance. It's not that big of a hassle. I have a

billing agent do the electronic billing and follow-up for $2.75 per

claim. That's definitely not worth my time... and it eliminates a whole

lot of hassle.

 

 

Geoff

 

> __________

>

> Message: 10

> Mon, 02 Jun 2003 16:16:30 +0000

> " Jocelyn Joy " <joyjocelyn

> Re: Re: entry DAOM

>

> Though I have not viewed all the messages concerning this

> subject 'DAOM', I

> do agree with Bob Flaws about questioning whether

> acupuncturists would want

> a primarily insurance reimbursement system for our services, I most

> emphatically do not. I relish having control over my schedule

> and time in my

> office. I am concerned that in our effort to gain 'mainstreaming and

> legitmacy' we will end up exactly where MDs and possibly DCs

> are now, with

> having to treat many, many patients in order to make a decent

> living. I

> enjoy having the luxery of spending most of an hour with my

> patients as I am

> able to keep an eye on their progress, pulse, etc and often I

> use this time

> to get more, in depth, information about my patients I might

> not have gotten

> had I been running from room to room. Many would not wish to

> practice in

> this way, but I do. If we train our patients to only seek

> treatment from us

> with insurance coverage and/or a very small co-pay, I guess

> we deserve what

> we get. Jocelyn Joy

[Guest guest]

, " Geoffrey Hudson " wrote:

> I'm wondering, do you take primary insurance reimbursement? I do,

and I don't have an insurance company dictating to me what my

schedule is. If I decide that I want to see a whole lot of patients

per hour, then that's my choice. I choose to see a patient an hour,

and I do just fine. I find that practitioners that have been in

practice for a long time usually are the ones who say 'just do a

cash-only practice' because they get frustrated in dealing with

insurance companies. >>>

 

 

 

 

Geoffrey:

 

Thanks for making this point. I know there are many practitioners

here in Colorado that also take insurance on a regular basis. I just

don't happen to be one of them, even though I would be doing more

business in these slow economic times. My point has always been

about having the option.

 

In their study on integrating CM with WM, Medical acupuncturists

have written that they expect, and are looking forward to, a time

when insurance providers include total coverage.

 

Having a both a doctorate and global insurance coverage would help

us to be more on par with WM and more integrated in the culture. If

money is power, we should make every effort to control our field;

our being integrated implies equality.

 

David Molony's warning about how herbal medicine could be taken away

from us should remind everyone that our profession is as much

political as acedemic. With these considerations in hand, the

exceptions that Flaws' brought up could be the norm.

 

 

Jim Ramholz