Jobs Post #3: the Toaster Tour

You just never know what might happen when you broach the topic of jobs for acupuncturists. I started out with a serious blog post, and thanks to Meaghan of Edgewater Acupuncture, next thing I knew I was running a toaster contest over the Internet. Then Keith Zabik of Tucson Community Acupuncture and Jessica Feltz of The Turning Point decided to play, which led to an unfortunate episode involving the aforementioned toaster (yeah -- just one), some glitter,  a few rainbow stickers, vomiting unicorns, and a power saw.

But that was just the beginning.

Nora Madden of Detroit Community Acupuncture had the revelation that the toaster should go ON TOUR -- perhaps, she suggested, to various bastions of the acu-establishment. Alexa Hulsey of East Nashville Community Acupuncture countered that it "should have its picture taken with all of the punks who have gotten jobs in community acupuncture clinics across the country". I decided that they were BOTH right.

It's not like I needed another project, but this one's irresistible. In part because, as they say, it's better to laugh than to cry. Before we get into the nitty-gritty, let's revisit the situation that has made our Toaster Tour possible!(And necessary.)

According to the NCCAOM Job Task Analysis, 91% of acupuncturists are self-employed. Only 9% have jobs.

60% of acupuncturists work less than 30 hours a week, though a majority of those would prefer to work full time.

Of that 60%, ALMOST HALF earn less than $20K annually -- and that's gross, not net -- from their AOM activities.

At my alma mater, the average student debt for an acupuncture graduate is almost $90,000. THE AVERAGE. Many people are graduating with debt loads of over $150K.

With that much student debt, it's often impossible to borrow more money to finance your own business; banks simply won't loan to you, not in this economy. And yet 91% of acupuncturists are destined to be self-employed. This situation is insane and certain conclusions are simply unavoidable. However, we've said all that before, so I'd like to move on and focus on the issue of jobs. In honor of Independence Day for us American acupunks, let's talk about creating jobs, which this country desperately needs us to do. Jobs in general, and jobs for acupuncturists in particular.

And by jobs I mean REAL jobs. Real, relevant and replicable. Let's revisit the criteria for those, also. Real means creating a position for an employee, not an independent contractor; a position that is protected by worker's comp and unemployment insurance, a position that yields a regular paycheck, a position that doesn't result in the "employee" paying self-employment taxes of 30%. Relevant means creating a position for an acupuncturist to practice acupuncture with actual patients, not creating a position for an acupuncturist to do something else, such as teach in an acupuncture school. Relevant positions cannot be funded by acupuncture school tuition, for reasons that I hope I do not have to explain. Replicable positions are just that -- they are not unique, they do not depend on extraordinary charisma or entrepreneurial savvy, they are a function of a funding stream for acupuncture that inevitably grows jobs for acupuncturists. As the funding stream expands -- as it should, because acupuncture works -- more jobs for acupuncturists come into being. Real, relevant and replicable jobs bolster the economy as a whole, and  they are also the best possible thing that could happen to the acupuncture profession in particular.

But who is going to create such jobs? And who is going to take responsibility for the terrible, horrible, no good, very bad economic situation in which the acupuncture profession finds itself?

Unless I'm gravely mistaken, comrades, I think we are. Nobody else even seems willing to talk about it. (More on that later.) So let's gird our loans and take pictures of toasters.

The Toaster Tour has two parts. The first takes off from Alexa's suggestion. If you have created a real, relevant and replicable job for an acupuncturist, we want you to take a picture of that acupuncturist with our special toaster.IMG_0645.jpg

If it's a living wage job, even better, and please note that. Owners of clinics, you can include yourself in the picture, if your job is also real, relevant, and replicable; meaning, if you were hit by a meteor tomorrow, would your job still be there and could someone who wasn't hit by a meteor hire someone else to fill it?

We'll start. WCA has created 5 real, relevant, replicable, living wage jobs for acupuncturists at our first clinic in Cully. Skip and I included ourselves because we could be replaced (we even have job descriptions to prove it!)

IMG_0655.jpeg

We have created 2 more real, relevant, replicable, living wage jobs for acupuncturists at our second clinic in Hillsdale. The Hillsdale acupunks were so excited about The Toaster Tour that a basic documentary-style picture wasn't enough for them. They had to have costumes and a photo shoot.  Even the toaster had to have a costume, courtesy of Joseph's crochet art:

IMG_0658.jpg

IMG_0663.jpegIMG_0660.jpeg

Having steady work is so relaxing! (Note: we only took pictures of our full-time acupunks, in part because they are easier to round up and photograph, since they are at work 5 days a week. We also employ 3 other acupunks part-time, 2 of them for 8 hours a week and 1 for 4.)

And hey, if you want to add a special detail of your own to the toaster when it comes to you, please do.  By the time it reaches its final destination in Tucson with Keith, it will be a veritable objet d'art! The toaster is next headed to Nashville in my suitcase for our workshop in 2 weeks, and probably from there to New England in Andy's suitcase or Cris', bound for Manchester Acupuncture Studio or Providence Community Acupuncture and more employed acupunks. 

The second part of the Toaster Tour involves, yes, a second toaster, which Joseph designed, and which will eventually end up with Jessica at The Turning Point.  I think of it as "The Toaster of Truth". Here's one side view (meaning, turn it sideways to fully appreciate -- sorry I can't seem to rotate pcitures):

2011-07-04_18-35-24_954.jpg

And the other:

2011-07-04_18-47-00_543.jpg

And the view from the top:

2011-07-04_18-51-39_466.jpg

This toaster will follow Nora's inspiration towards prominent people in the acupuncture profession. I'd also like to include some other bloggers and various acu-friends of CAN, just to gather as much information as possible. We will invite them to answer the following questions, and we'll post their answers on this blog:

1)  Looking at the recent NCCAOM Job Task Analysis, why do you think there are so few jobs for acupuncturists? What do you think that says about the acupuncture profession?

2)What jobs for acupuncturists do you know of that fit the criteria of The Toaster Tour (real, relevant, and replicable)? Please list them, including the nature of the funding stream that supports them if you know it. We will try to independently verify them, of course.

3)Who do you think is the largest employer of acupuncturists in the U.S.?

4) In your opinion, what groundwork needs to be done in order for more acupuncturists to have real jobs? Who is responsible for doing that groundwork?

5) The availability of jobs for acupuncturists is a pressing concern because students are now graduating with so much Title IV debt that it is impossible for many of them to start a business, which means more and more graduates are never able to practice acupuncture at all. What do you think is the solution to this problem? And who is responsible for addressing it?

Respondents to our questions may, if they would like, have their picture taken with the Toaster of Truth. If they fail to respond to the questions, a picture of the Toaster of Truth will be taken outside of their respective institutions  and their lack of response will be noted on this blog. (Comrades, this is going to involve some local legwork in various states, so if you are willing to help, please contact me at info at workingclassacupuncture dot org or post a comment on this thread in the CAN forums.)

Obviously, this is a big project and could result in a lot of posts. But I think it will be worth the time and trouble. You know that saying, qi follows yi, or energy follows attention; the more attention that we put on jobs for acupuncturists, eventually, let's hope, the more of them they'll be. Happy Independence Day!

This story was posted on July 4 2011 by Lisafer.

Comments

  • July 4 2011 at 1:02 AM
    David Lesseps writes:

    as of June 27…

    ... not counting my partner or myself, we now have 3 payrolled employee punks.  No more independant contractors for us.  3 punks receiving paychecks with taxes withheld, etc.  If they get hit by meteors, we will try our darndest to replace them.

     

    David L f’ing Ac (my earned title)

      0 likes
  • July 4 2011 at 1:20 AM
    Lisafer writes:

    maybe I should bring a toaster to the Bay Area meeting…

    Hey David, a couple of questions:

    are your payrolled punks part-time? Are you and your partner on the payroll as well? 

      0 likes
  • July 4 2011 at 2:00 AM
    David Lesseps writes:

    pm

    sent you a email.

     

    David L f’ing Ac (my earned title)

      0 likes
  • July 4 2011 at 8:29 AM
    ellengrover writes:

    all punks on payroll in philly

    (including me) ... send that toaster out!  

      0 likes
  • July 5 2011 at 4:00 PM
    alexa writes:

    4 punks in Nashville (myself included)

    Can’t wait to have our picture taken!

      0 likes
  • July 6 2011 at 9:31 PM
    Vella writes:

    WOW!  Not only do I get a

    WOW!  Not only do I get a paycheck for doing acupuncture (month after month no less), but I get to have a picture taken with my cohorts

    and a tiny rainbow puking unicorn!

    (soft sigh)...I love community acupuncture in new ways all the time… 

     John 

      0 likes
  • July 8 2011 at 12:29 PM
    Guest writes:

    I’ll be waiting, too!

    Christus St Vincent Regional Medical Center, Santa Fe, NM Integrative Medicine Program Created by me, Eric Raymond Buckley, DOM. Wrote all the policies and procedures, created the documentation. Program approved unanimously by Medical Executive Committee. Have two treatment rooms and an herbal pharmacy. Work (doing acupuncture in the outpatient clinic, integrated with PT, OT and SLP. Also in the emergency department (ER). Also in the inpatient setting on the med/surg floors and inpt rehab. Hired another DOM 6 months after me who works in the Cancer Center. We make $69,000 a year and get ONE MONTH vacation/sick time, salaried. I graduated in 2008. Wrote my own job description. I’ll be awaiting my picture with the toaster, too!
    Eric

      0 likes
  • July 8 2011 at 2:10 PM
    Lisafer writes:

    Great!

    Couple questions: what is the funding stream for your position? Do you treat patients who have insurance that covers acu, and then the hospital bills for it? Or does the funding come from somewhere else? If so, how stable is it? Same funding for the 2nd position that you created? And finally, can you tell us what it would take to replicate your positions elsewhere, and why this is or is not happening?

      0 likes
  • July 8 2011 at 2:39 PM
    Guest writes:

    I am so thankful to be in

    I am so thankful to be in the above picture, with the toaster, and my fellow co-workers.  (To even say that I have co-workers in the acu-profession is rare, as many acupunks work alone).

    I realize that being an employed acupuncturist, seeing a regular stream of patients, and receiving a stable paycheck, puts me in a very uncommon position as an acupunk.  This, of course, is really sad.  If I did not have an acupuncture job, I would have to either go back to school to learn a new trade (as acupuncture is my “first” career and I don’t have another one to fall back on), the years and money spent in acu-school would have been a waste of energy and money (debt-load), and I would not have the opportunity to provide acupuncture (and do what I really want to do for a living) to lots of people that are under-served due to the extreme lack of healthcare accessibility.  So, yes, to say the least, I am happy to be in the picture, with the toaster.

      0 likes
  • July 8 2011 at 4:12 PM
    Guest writes:

    Keep the faith

    Hi,
    The funding stream mostly comes from insurance. In New Mexico, all private insurance must cover acupuncture by legislation. We also get coverage by a state fund called the “Indigent Fund” that covers health care costs for low income people that get treatment in hospitals and clinics in Santa Fe county. We do have some cash patients as well. Same for the second position.  Herbs are paid for in cash.
    I think a big part of why this was able to happen is that western medicine sees the writing on the wall. They know how to solve acute problems, but have very little solutions for chronic diseases. Chronic disease is the challange of the future of health care. We provide solutions to problems that are draining the system. Things will get better for us, it’s just going to take more of time.
    I can name some hospitals that employ Lacs, but its not many. One of the things that it will take to get more of us into these positions is more western medicine education. If we can’t communicate what we do to the rest of the health care system, in their own terms, then we will always be isolated. Our schools certainly don’t deliver what we need to succeed. Another thing that we need is to remain confident. We are the resident experts of a medicine that delivers results. If we can be confident, articulate and deliver results, time will yield to us a solid place in this country.
    I appreciate the awareness that CAN brings to the plight of LAcs. It’s pretty bleak! I’m doing my best to help turn things around.
    Peace.

      0 likes
  • July 8 2011 at 4:34 PM
    Lisafer writes:

    great information, thank you for sharing it!

    Eric, can you give us a list of the hospitals that employ L.Acs that you know of? If you know how many they employ, even better, and how the positions are funded. Wouldn’t it be awesome if we could create a database of L.Ac employers?

    In no way do I intend to be stingy with the toasters, but there are just a couple more things I need to know before I send yours. It is clear to me that your job is REAL and RELEVANT, but I need to know more about its REPLICABILITY.

    1) I don’t know if you saw the earlier post about the CTCA job, but it turns out that their L.Ac positions require 3-5 years experience. Did your job, or the one you created, require any special experience or qualifications?

    2) Can you describe the process by which you created your job and the next one? How long did it take, start to finish? Did you need to, for example, create cash-flow projections or negotiate directly with any insurance companies? Where did you START in terms of convincing the hospital that it was worth their while to add 2 more positions to their payroll? How did you make your initial contact?

    3) Most importantly: at what point did you decide that the funding stream was stable and expansive enough to replicate your job? And since it sounds like you are on a roll, when will you be able to create position #3? Are there any factors that might prevent you from replicating again? What do you need in order to create more positions like the one you just created? Is the hospital supportive of you creating more jobs for L.Acs? Why or why not, etc?

    If the boxes get too skinny here, I would be happy to give you  your own blog post to explain the nitty gritty details of how you pulled off this miracle.

      0 likes
  • July 8 2011 at 7:06 PM
    Guest writes:

    Toaster me, please!

    I really love the toaster idea. The one with the unicorns farting and puking rainbows and that has the cuts of meat is my favorite! Totally hysterical! Please send me one like that, if you deem me to be worthy smile

    1. The qualifications I wrote into the job description read like this:
    MINIMUM QUALIFICATIONS:
    Education: Masters Degree in Oriental Medicine
    Certification/Licenses: Current New Mexico Doctor of Oriental Medicine (same as an LAc) licensure, certification as a diplomat of Oriental Medicine through the NCCAOM, and BLS required.
    Skills: Demonstraites accountability and skills in acupuncture, moxibustion, medical herbalism, physical manipulation (tuina), cupping, nutritional therapy, and lifestyle counseling. Demonstaites strong interpersonal, verbal and written communication and organizational skills.

    That’s it. The idea is to have opportunities for new practitioners, not veterans. We need to create opportunities for ourselves similar to other professions when they get out of school like nursing and PT - jobs for new grads.

    2. It all began when I was going to SWAC and decided that I wanted to work in a hospital, like I had seen in the hospital that I did an externship with in VietNam. So I went and applied for anything clinical that I could get, which turned out to be a nurses aid in the psyche ward. I worked my way around a couple of positions, taking better opportunities when they were offered. All the time, learnng as much about the system and western medicine that I could, while my SWAC education gave the skills for eastern medicine. I presented myself professionally and respectfully, not with a superiority complex about my acu-knowledge, and offered information to whomever would listen (without being annoying) of what acupuncture and herbal medicine offers. I got to know everyone I could and made valuable professional relationships. Then, when I graduated, I offered the most appropriate person in the administration that I could think of to create an acupuncture program for the hospital, as long as I could make money from it. They returned with, “We’ll hire you to make a program for us.”
    Students - go get a job in a hospital doing anything clinical or administrative - and then put your best foot forward! If that’s what you want to do…

    I never negotiated anything with insurance companies. Hospitals have their own contracts with payers. They do the talking. I did not have to create cash flow projections but I did have to show where the money was going to come from and how much we were going to charge. I also had to interpret everything into CPT codes, which is the billing language of western medicine. I did have to come up with a budget, but everyone knows that budgets come out of thin air. And you make them conservative so that you can beat the projections easily. Then I researched all of the hospitals that I could find that had acupuncture programs. And then I started calling them and asking for who was in charge. Then I would ask them as many questions as they would let me trying to find out how they did it. I got a lot of help from other existing programs. We need to help each other and not worry about competition, like you guys always talk about, there is pleanty of room!

    3. My director hired the second DOM, not me. I thought it was too soon to do so, but the strategy was to have an available DOM for anytime of the day that someone wanted to come. Meanwhile, I started going around to other parts of the hospital looking for referals. One of the natural places was the cancer center. I began going to their chart rounds and talking with the nursing staff mostly. I gave them all of the research that I could find that shows how acu helps cancer patients. They became so enthused they decided to hire the other DOM that was working with me as a full time practitioner. We just cut and pasted everything from this department to that one: documentation, policies, equipment, the works.

    I have been getting a lot of my referals from the Emergency Department (ER). They are very excited to have an alternative to dolling out pain meds like there’s no tommorrow. I have been treating in the Department when I have a hole in my schedule and billing from there. I do the same for the Inpatient floors. This helps the staff to see what we can do so they know when to refer. It’s a lot of fun! I hope this will naturally progress into the doctors seeing us as a necessary part of the staff. Hospitals do what doctors tell them. This is an essential part of the equattion to understand. It is getting to the point where there isn’t enough of me to go around. I hope this will lead to the departments wanting to hire the next DOM. Time will tell…

    Pick your format and don’t let anyone tell you that you can’t do it! I HAD to do it this way because I am seriously in debt and don’t have a family bank role to fall back onto. I feel lucky, but I busted my ass to get here. Nobody handed me anything that I didn’t earn.

    If anyone is interested, all of my information is open source. Everyone is welcome to see the accumulated documentation that I have in order to replicate this position. I am always available to answer questions. Attitudes in medicine are changing and we need to step up and take our rightful place.

    Is that the answers you were looking for? There is much more to say, but I have to go home now, it’s been a long day.

    Eric

      0 likes
  • July 8 2011 at 10:49 PM
    Lisafer writes:

    I have an idea

    Eric, how about if you answer the 5 toaster tour questions above, and also, if you don’t mind, write out a detailed description of how you created your job, send it to me all in an email: info at workingclassacupuncture dot org, and I will devote an entire post to this.

    I think we need to talk more, because I’m still not sure about the replicability aspect—but let’s save that for the post because we’re headed for skinnyboxland. OK?

      0 likes
  • July 8 2011 at 11:14 PM
    Jessica Feltz writes:

    5 Questions, for your convenience Eric:

    1)  Looking at the recent NCCAOM Job Task Analysis, why do you think there are so few jobs for acupuncturists? What do you think that says about the acupuncture profession?

     

    2) What jobs for acupuncturists do you know of that fit the criteria of The Toaster Tour—real, relevant, and replicable?  Please list the jobs, including the nature of the funding stream that supports them if you know it. We will try to independently verify them, of course; any contact information you have is greatly appreciated.

     

    3) Who do you think is the largest employer of L.Acs in the U.S.? How many jobs does the largest employer provide?

     

    4) In your opinion, what groundwork needs to be done in order for more acupuncturists to have real jobs? Who is responsible for doing that groundwork?

     

    5) The availability of jobs for acupuncturists is a pressing concern because students are now graduating with so much Title IV debt that it is impossible for many of them to start their own businesses, which means more and more graduates are never able to practice acupuncture at all. What do you think is the solution to this problem? And who is responsible for addressing it? 

      0 likes
  • July 11 2011 at 12:34 AM
    zumbro writes:

    Just a few

    thoughts after reading the posts, wow! noble work all! I am happy I went to school (Midwest College) back in the day tuition cost about $2000/yr. I graduated & took NCCA (now NCCAOM) in 1988, got my first job w/Hennepin Co. CD program (Minneapolis), happily making $15/hr! Got laid off 2 years later & may have been the first acup. to collect unemployment! Anyways that was PT & I always had a private practice. Most all the hospitals in the Twin Cities (& Rochester, MN/Mayo & more) have LAcs (read: lacks), not sure the pay grade. Hopefully someone from the Acupuncture Chat group will link to get their comments. Thx again for the awesome input. PS. I am looking to hire LAc for my CAP in Rochester! 

    Deah Kinion, L. Ac.
    (507) 990-3299www.abundant-chi.comwww.zumbrovalleyacupuncture.com

      0 likes
  • July 11 2011 at 2:11 PM
    Guest writes:

    Sorry to crash your party

    Hi Lisafer,
    Wow. It looks like I’m being held to a little bit of a different standard than your average bear. That’s ok though, I really don’t need a toaster. I make enough money to buy my own. But, as to your larger point, who uses toasters anyway? They are about as useful as… as… oh yeah, a degree in acupuncture, right?

    I’m sorry I crashed your party. I really do appreciate the awairness that CAN brings to the fact that the schools are ripping off students. I have witnessed first hand the oppulence that some schools and owners display on the backs of our financial aid. In a word, it’s bullshit.

    I will humor you by answering the five questions as a reply to Jennifer’s post. But as far as the rest of it goes I was just having a little fun, just like you with the toasters but with a serious undertone. I see your point that CAN is one of the only sustainable economic options for people that chose this education. Thank god someone is doing something for our grads! You guys are great at building community out of a crappy situation. Some change things from outside the system, some do so from within. I hope to have a positive effect by exposing the western medical world to the reasons why we should be taken seriously.

    As I said before though, everything that I have done at this hospital I consider to be open source. If you really do want more information, feel free to contact me @ 505.913.5123. My personal email is .(JavaScript must be enabled to view this email address). My work email is .(JavaScript must be enabled to view this email address). I don’t really need a post devoted to this. I just wanted a toaster with the unicorns… so funny! Anyone who reads this is more than welcome to contact me and ask questions. Just please don’t cuss me out because I happen to be a loud mouth. I already know that. It will do no good.

    What I can provide: Policies and procedures with which to opperate in the hospital environment. Salery numbers. Charge masters. Documentation. Advise on what one would need to start a hospital based program. Examples of good working models and not working models. Contact information for other successful programs. And more.
    Bueno,
    Eric

      0 likes
  • July 11 2011 at 3:16 PM
    Guest writes:

    5 Answers

    #1 There a so few jobs because we learn a way of understanding the body that is vastly different than western medicine. It is our responsibility to translate our understanding into something that our culture can more easily approach. Our schools have kept us separate by remaing in private hands. This education should be put into community colleges and universities. It would then be easier to be accepted as part of the health career culture. It tells me that we have a lot of work to do for our future students and patients to help this medicine become more widely accepted. It also tells me that the acu-establishmet has built a bubble that will pop over the hopes and dreams of hapless students.
    #2 Schools, private practice, CAN clinics, hospitals, cruise lines, spas (although my opinion considers these last two to be irrelavent.) Oh yeah, there is also a lot of us working at wholefoods and as waiters. To give a specific example, see #3.
    #3 The largest employer I can think of is Integrative Therapies at Longmont Hospital in Longmont Colorado. They have been around for like 14 +/- years. I think they have like ten practitioners or something. In a broader sense. You can find them with a google search. Acu schools are the largest employers (although these people are teaching primarily and doing acu primarily.) It backs up the old addage that those who can’t do, teach. In other words, there are no jobs, there is only financial aid.
    #4 Well more schools obviously (just kidding). We need a better education than the crap the schools feed us. Part of the problem is that a lot of the people who choose this education are anti-establishment freaks, so you get very poorly run schools, because that’s the only place to get a job. We also need to learn to communicate better with the other people who work in medicine, no matter what their title. In general, we need to become more inclusive and not remailn exclusive and opposing. We are responsible.  We got stuck in the butt by the acu-man with empty promises. It our job to turn it around into something good.
    #5 Let’s think. I took out the student loans, whether based on false premise or not. If I hadn’t, I probably still be picking arugula and onions every day. Well no more dirt farming for this guy! Woo hoo! But seriously though, the solution is for us, as practitioners to make the world a more hospitable place for us and our medicine. Get the education out of private hands and into the public schools. The teachers would get paid better and have more respect, too.
    We are responsible for making a better future from the crap we were handed and the crap we were born with. Sucks, huh smile
    Eric

      0 likes
  • July 11 2011 at 4:09 PM
    Jessica Feltz writes:

    I’ll repost this above

    as its own blog.  Boxes are getting too skinny to respond properly here.

      0 likes
  • July 12 2011 at 1:20 AM
    Lisafer writes:

    you have won my heart, Eric

    not to mention the unicorn toaster, with your detailed disclosures. Also, you get bonus points for transparency in trying to help other punks follow in your footsteps and  create jobs. As for why I am being such a stickler about replicability, please see this post above.

      0 likes
  • July 13 2011 at 11:45 AM
    Guest writes:

    Yeah!!!

    Thanks, Lisafer!!
    Your heart alone is worth a thousand million unicorn toasters!!!
    Eric

      0 likes

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