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OCOM Redefines Acupuncture as a Hobby for Girls

I’m an alumna of the Oregon College of Oriental Medicine, class of 1994. For years I’ve been teaching workshops in which I joked that my partner Skip (OCOM, class of 1993) and I developed the Community Acupuncture business model simply because we couldn’t make use of the prevailing business model for acupuncture success. No, not the conventional private practice model, the one that people think of as predominant; I mean the truly prevailing business model for acupuncture. That would be “the Sugar Daddy business model”, in which an acupuncturist asserts that  he or she is successful in his or her practice, because in reality he or she doesn’t need to earn a living, since his or her partner/husband/ wife has a real job and supports their household. Plenty of acupuncturists, regardless of gender, claim this kind of success.  The difficulty for me and Skip was that both of us wanted to be acupuncturists. Neither of us was willing to quit acupuncture and to get a real job in order to be the Sugar Daddy, and so we both became social entrepreneurs instead. Audiences generally laugh at this line, but it’s also a pretty accurate description of the beginning of the community acupuncture movement.

I never expected to see -- in print! in an official professional journal! -- such a serious,  candid endorsement of the Sugar Daddy business model as “The Changing Demographics of Acupuncturists”  by Susan A. Sloan, MBA, Jamie Reeves, BA, Miles Sledd, LAc, and Jason Stein, LAc, published in the Fall 2012 edition of the American Acupuncturist. Since all four authors work for OCOM, apparently the institution itself is formally embracing the Sugar Daddy path to success for its graduates. And it goes much further than simply endorsing the model: it blames the lack of evidence of thriving acupuncture practices among OCOM graduates on -- wait for it -- women.

“While income,  hours worked and rates charged might seem somewhat low in relation to what education level and expectations for professionals in general society might dictate, we do not see concomitant dissatisfaction among OCOM’s graduate practitioners.”  (Page 16) And you know why? Because they’re girls! Never mind all that terrible, horrible, no-good, very bad workforce data about the acupuncture profession. It doesn’t mean what you think it means, because things have changed. Acupuncture is just a hobby for girls! And girls don’t want real jobs! Because economics aren’t important to them and also, they believe in Taoism, because we teach them to! Isn’t that a relief?

(Note: I do not mean to suggest here that people who choose part-time paid employment in order to work inside their homes, with their families, are not doing real work. By real jobs I mean what I wrote about in this blog post awhile back. Spoiler alert: the reason there are so few real jobs for acupuncturists is not because women want to have babies.)

It seems to me that this article has other problems as well. That is, if I understood it correctly, given that I am an acupuncturist and a girl, and thinking about economics is a real stretch for me. In fact, since I was 26 when I graduated from OCOM in 1994,  I was probably the first representative of the young female graduate demographic which is apparently the source of the poor economic performance of the entire acupuncture profession. Currently my business employs 12 other acupuncturists,  four of them young female alumnae of OCOM who inexplicably want to work full time for a living wage. Go figure.

In fact, let’s start there. The article opens with statements like, “There is... no agreed upon measure of what constitutes economic success in an AOM practice” and “Little research about the AOM profession itself has been undertaken, and little is known about AOM professionals”. (Page 13)  Someone like me -- a girl acupuncturist for the last 18 years who clearly doesn’t get it -- might interpret the lack of information, structure and definition within the acupuncture profession to indicate that, by any normal standard, we don’t really have a profession at all. If lots of us were busy and successful,  of course we would have measures of what constitutes economic success.  If there were more “AOM professionals” who were actually working, we would naturally know more about them. Representatives of OCOM see it differently, of course. This empty landscape where jobs, data and research should be isn’t a sign of serious structural problems with the profession; that landscape’s not really empty, it’s just full of girls, doing girl things. Because they like it that way.

Similarly, in discussing the NCCAOM Job Task Analysis, the authors try to steer around explanations that seem obvious to anyone who’s been an acupuncturist for any length of time: “Therefore, it may be that the very significant proportion of respondents in their early years of practice may have caused the overall financial success estimation of the AOM population to be significantly understated...” (page 14)  It is equally likely, of course, that the attrition rate of the profession is so high that there are proportionally many fewer acupuncturists with more than 5 years of experience to respond at all.

Acupuncture schools like OCOM have been quite successful at teaching their graduates to focus on the imaginary ideal of being an acupuncturist and to ignore the economic reality. The professional culture of acupuncture, such as it is, is steeped in fantasy. This has to be taken into account when we discuss acupuncturists’ self-reported “ideal practice volumes”. A 2009 graduate of OCOM described a practice management class in which a guest speaker, another OCOM alumna and “successful acupuncturist”,  told the class in glowing terms about her practice, in which she was achieving her ideal practice volume of 3-6 treatments a week. She was very satisfied with this and found it very sustainable. She neglected to mention to the class that she is married to an MD. So, when “(o)n average, graduates said they were treating 70%-80% of their ideal practice volume” (page 16),  this does not mean that they are earning 70%-80% of their ideal income from their practice. When acupuncturists describe their ideal practice volume, they are not necessarily describing economic viability at all.  And of course, lots of people would “prefer” to work less than full time. Does the acupuncture profession allow them to do that and support themselves -- or their households -- and pay back their student loans?

The OCOM data doesn’t address that question, or -- conveniently -- a number of other questions:

1) “OCOM’s 2007 and 2010 surveys of graduate cohorts 1994-2010 found that, respectively, 91% in 2007 and 88% in 2010 were actively in practice in 2012.”  (Page 15) For the 39% and 38% of the cohorts who say that they are not working full time, what does “actively in practice” mean? Does it mean they are doing one treatment a month? Does it mean they are treating their husbands every day when they come home tired from their real jobs, greeting them at the door in an apron with a stiff drink and a packet of needles? Who knows?

2) For the 61% and 62% who report being in practice full time, are those income numbers gross or net? Although the authors are eager to put acupuncture practice into the context of small business and self-employment for other measures, they don’t do it here. Take home pay for a small business owner can be 50% less than gross income, especially if they have an employee who is providing reception services and insurance billing. There’s office rent, supplies, utilities, marketing -- the list goes on and on. Failing to clarify whether the income that is self-reported is gross or net makes these numbers highly questionable.

And while, in terms of studies, the OCOM data may technically represent a good response rate, in real terms, I believe we’re talking about a  relatively small number of people. 86 plus 82 equals 168 people, if my ladybrain is keeping up here. 61% is 52 people averaging 72K gross for full time employment;  62% is 51 people averaging 106K gross for full time employment.  OCOM managed to find 103 graduates who self-reported what might be take-home income of anywhere from 36K to 75K for full time work after an unknown number of years in practice. This does not translate to, “Relax everybody! The acupuncture profession is just fine!”

3) An assessment of the escalation of commitment/sunk cost fallacy in graduates’ self-reported satisfaction with their practices. When people have invested significant time and money into a course of action, it’s very difficult for them to say that they regret it. The more they invested, the more difficult it is for them to decide that it was a mistake, no matter how it actually turns out for them. So will graduates who are barely working and barely earning any income report that they are happy to be acupuncturists? Of course they will.

4) A crucial set of numbers that are missing from the OCOM data is student loan indebtedness relative to acupuncture practice income. My understanding is that the average student loan debt for the OCOM graduating class of 2009 was around $88,000. What is the impact on a household’s finances of a graduate who is bringing in a gross income of $32,000 for part time work and trying to repay student loans of this magnitude? What happens to someone’s quality of life when she is facing a debt that she may never repay?

And finally, what happens when there’s no Sugar Daddy in the picture? A few years ago, a recent OCOM graduate came into my practice to ask about a job. Just as the article describes, she was female, in her early thirties, and she had a toddler in tow. Like many of her classmates, she had opted to start her family during her last year of OCOM. In her case, however, it didn’t work out. She and her partner broke up. She had financed her education on student loans and she had no capital to start a practice. She showed up in my clinic because she was on welfare, and her caseworker required her to apply for acupuncture jobs anywhere and everywhere. She had been looking for months, of course, and had found nothing.  In the Sugar Daddy business model, it’s the ongoing commitment of the Sugar Daddy that determines the difference between an OCOM graduate working part time by choice and an OCOM graduate living in real poverty. The authors of the article omit this crucial distinction from their new definition of acupuncture success for girls.

I found the last sentences of the article particularly striking: “The authors are employed by Oregon College of Oriental Medicine. There are no financial or conflicts of interest to disclose.” (Page 18) Of course, this is just one more observation by a girl, but it seems like most real, stable jobs in the acupuncture profession are in acupuncture schools, funded by a steady stream of students taking out federal student loans in hopes of someday having a career themselves.  Certainly these kinds of jobs are eagerly sought after by almost any OCOM graduate who can get them. Are the authors suggesting that they themselves do not personally benefit from having jobs? Especially when those jobs probably represent more reliable, consistent take-home income than most acupuncture practices do?

The question is, of course, whether this entire article is anything other than an impressively disingenuous response by OCOM to the troubling recent studies of the acupuncture workforce.(Perhaps any awkward questions from the Department of Education about post-graduate employment can be dispelled simply by explaining, “It’s not our fault our employment numbers are so dismal! It’s because our school is full of girls!”) Does OCOM really mean what it says in the article: “If the trend to a younger, female-dominated profession continues, there may be significant implications for the individual, the institutions that prepare them, and the profession as a whole”? If so, I would expect to see a number of changes in short order, such as:

A drastic reduction in OCOM’s tuition. If acupuncture practice is a hobby for girls, why does acupuncture education cost upwards of $100,000?

An end to justifying  acupuncture tuition costs by comparing them to the costs of medical school or other graduate training programs, which are designed to lead to full time employment and actual careers.

A drastic reduction in the length of the program and an immediate, wholesale retreat from the  institutional rhetoric that characterized the debate over the First Professional Doctorate, which OCOM supported. Are acupuncturists doctors, who need to be called "doctor"? No, they’re girls; they need to be called "Mrs." Do acupuncturists need a doctorate because they want to work in hospitals? No, they’re girls, and they don’t really want to work at all. Perhaps OCOM could petition ACAOM to formally recognize the "MRS AOM" degree. I give you my word, the community acupuncture movement won't protest that new degree AT ALL.

An immediate revision of the OCOM website, catalog, and admissions application. The website and catalog should feature prominent disclaimers that an OCOM education is not intended to lead to economic gain, full time employment, or anything resembling a career.  The admissions application should require incoming students to list the name and income of their designated Sugar Daddies.

And finally, OCOM should re-paint all its facilities. They would look much better in pink.

This story was posted on November 8 2012 by Lisafer.

Comments

  • November 8 2012 at 1:08 AM
    Pauline writes:

    The notion that the authors have no financial stake in their"research” is an absolute hoot! They’ve been in the business for years telling naive suckers they can make a mint at acupuncture, and that’s how they make their money.
    What I also found interesting is that this new information about their changing demographic meant they were going to have to make some curricular changes. Like maybe the lecture on practice development:
    “Now girls, if you really want this acupuncture thing to work you’re going to have to go out and find a nice man with lots of money.No, no, I don’t want to hear you whine about this. Now go fix your make-up.”

      7 likes
  • November 8 2012 at 9:11 AM
    Spartacus writes:

    One of the most significant things I learned from my statistics class in undergrad was this: statistics can lie.  A person can manipulate statistics to make them appear to say almost whatever they would like, and it’s mostly because most people have not been taught how to do a rudimentary analysis of them.  I found it really difficult to get through this article not only because of its offensive sexist tone, but also because these jokers are using data from two samples that are quite literally MICROSCOPIC in relation to the tens of thousands of acupuncturists that make up our “profession” that they are attempting to say something about.  But they’ve coated it in a nice thick layer of academic-sounding officialese so that helps it sound accurate and smart. It’s really too bad that they’re clearly setting up a line of reasoning that further supports the “profession” burying their heads even deeper in the sand (I nearly spit my morning coffee across my laptop when I got to the part about choosing balance over “merely maximizing” earning potential - as if we don’t need to first maybe get to a place of minimal earning to pay bills and meet our immediate needs). 

    I won’t be at all surprised when the next JTA has *merely* two questions: gender, and “How happy are you?” That’s about the level of scientific analysis and accuracy these folks are interested in, much to the detriment of their students. The writers of that article don’t want to know anything about where the profession has been, or where it is now, and that means they have zero interest in where it is actually going. Preposterous rationalizing is clearly enough for them.

      7 likes
    • Lisafer
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  • November 8 2012 at 2:18 PM
    mollyfread writes:

    Those are such good points, Kim, particularly about the ‘microscopic’ data they’re analyzing. I felt horrified by the end of the article, offended, eyes wide and mouth agape. I am so angry. I fit right into the “new demographic” as a female in my early 30s, and I think it’s disgusting for the authors to “scientifically” propose that largely we are all out here CHOOSING to work part-time because likely, we’re raising families. I’ve got no Sugar at home paying my bills and I don’t want any goddamn babies. I have worked my butt off for the last 2.5 years to ensure full-time work and a living-wage income. I don’t resent that fact at all; I never thought it’d be easy and I’m very proud of my accomplishments. I realize my income level would place me in the lower brackets for acu-grads, and that those who equate success with higher gross income might now, after reading the article, assume that I’m focusing on my (non-existent) family, or that I’m just not driven enough (see below quote).

    “As for self-employed men, Tuttle found that men generally are more focused on life satisfaction factors in self employment(for example, degree of autonomy and how work is performed), and they generally choose to put more hours into their businesses(averaging 49.5 per week) than self-employed women. Although Ward-Cook and Hahn do not specify desired work hours per week by gender in the AOM study, these other workforce studies hint that the 30% minority of AOM practitioners who are male might well be concentrated within the 52.7% of practitioners who seek to work 40 or more hours per week. By the same token, female practitioners, especially those with young children, may be more likely to be clustered among those desiring part-time hours. Further
    research is needed to confirm whether this assumption is correct for part-time acupuncturists.”

    Oh, so let’s just ASSUME that the hard-working male minority of the acu-profession likely comprises the 52.7% working 40+ hours per week. Because they’re men, so they’re more driven. Of course. All us girls are content to put in fewer hours both working in and developing our businesses, to manage the details of childcare and have enough time in the afternoons to bake a pie in time for its sweet smell to permeate the house *just right* for when Sugar walks in the door. The above quote in no way represents the women I know in the community acupuncture movement, who ALL work their butts off so that their clinics will grow and provide them with sustainable, reliable jobs.

    Perhaps OCOM should include this link as part of their welcome package (Thanks, Zem): http://ourfemininemystique.blog.com/2012/08/30/11-reasons-to-marry-a-traditional-man/

      5 likes
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  • November 8 2012 at 3:56 PM
    chico community acupuncture writes:

    I am so proud to have moved back to my home town in 2010, created a job for myself, two part time receptionists, and another acupuncturist.  I never dreamed of not working as an acupuncturist while I was in school (when I graduated). I have high high student loan debt.  At this point it is compartmentalized as just one of several monthly payments that I make.  Where was the career councilor?  I remember touring an acupuncture school on the East Coast.  I asked the admissions person what the job potential/income potential was for an acupuncturist.  She didn’t know.  Hmmm.  Pretty basic question.  When will the racket end?  Thank you POCA TECH.

      3 likes
  • November 8 2012 at 5:22 PM
    ellengrover writes:

    been watching too many episodes of Mad Men OCOM.

      3 likes
  • November 8 2012 at 6:55 PM
    acupunkgirl writes:

    When I read this blog post by Lisa I thought, Hmmm. I feel like I just read about the same thing…. so I had to figure out where I had read it before.  I knew I hadn’t been reading the American Acupuncturist!

    It’s pretty clear that the person who wrote this (link posted at the end of my note) is all rainbows and kittens and lots of empty but pretty pink wall space.

    Here’s just an example of the spin from this ‘review’ of the AA article:

    “Recently, I read an article co-authored by a friend of mine. It was about the changing demographics of acupuncturists and was published this fall in The American Acupuncturist (to read the article see the link attached at the end of this post).

    The article looked specifically at acupuncture and oriental medicine (AOM) practitioners using data from the Oregon College of Oriental Medicine (OCOM) and other sources. The authors are administrators at OCOM (and they are awesome). The data revealed an emerging trend in who is becoming a practitioner and how it is they choose to design their career and define success.”

    Later they go on to pooh-pooh other findings on this topic:

    “Another previously written article (by Stumpf, Hardy, Kendall & Carr) had deduced (incorrectly) that since many practitioners work part-time it shows lack of success in the medicine. This is based on the assumption that working 40+ hours a week is a measure of success and desirable by all. Because of this, they said it shows that there is not enough work and they are working fewer hours due to lack of a thriving field, a “over-saturation of a underdeveloped market, where practitioners are targeting the same market segment.”  ”

    I’ll stop here, for obvious reasons (choked up with vomit, if you must know).  Here’s the link to the pink stardusted drivel: 

    http://stardustbizservice.com/2012/11/04/acupuncture-demographics-and-defining-success/

      1 likes
  • November 8 2012 at 8:18 PM
    Whitsitt writes:

    Yesterday, after working the morning shift at my acupuncture job (you know, the one I rely on to pay rent and feed my family), I went home in the afternoon and actually baked a pie with my daughter.  Because I’m a driven man, and that’s just the sort of thing I’m driven to do.  It was apple, to celebrate the election.
    This study is ridiculous.  I’m not even going to bother parsing out all the fallicious reasoning and internal contradictions (Stumpf’s study couldn’t be true because they used too much data/ no one has done a good comprehensive study yet, for example) because I’ve got pie to eat and chlidren to raise.  Not to mention patients to treat.

      10 likes
  • November 8 2012 at 8:47 PM
    michael writes:

    Thanks Lisa!

    This sugar daddy has a check for poca tech, where should he send it and to whom should he address it! 

      4 likes
  • November 9 2012 at 12:14 AM
    Lisafer writes:

    Aww, thanks Michael! Make it out to POCA Tech but send it to the POCA office care of Carmen: 3526 NE 57th St., Portland OR 97213 (same address as WCA but it has a door around the corner).

    Yeah, next time anybody asks me why we need yet another acupuncture school, I know what to give them to read. How are we supposed to get workers for our clinics when the schools have given up on people working? Oh wait, no, it’s just women that they’ve given up on. Right.

      3 likes
    • mollyfread
    • Roppie
    • Spartacus
  • November 9 2012 at 11:54 AM
    ReneeK writes:

    Am I reading this incorrectly? How does 86/82 respondents = 57/55% when the total number of OCOM graduates is 1100? The response rate to the questionnaire is more like 8% if it was sent to all graduates. This is on page 14/15 of the article.

    “In both of these OCOM graduate studies,
    randomly-selected samples were selected from each of the cohorts.
    Response rates were 57% for the 2007 study (86 students) and
    55% for the 2010 study (82 students).”

    Whenever “studies” like this are published I get depressed.

      3 likes
  • November 9 2012 at 5:25 PM
    Shauna writes:

    The OCOM authors claim that a large percentage of women in AOM programs is an “emerging trend” is not a news flash. The attempt to link their 2007 and 2010 alumni surveys to this “emerging trend” and claim that women are working part-time in this profession due to preference, quality of life, etc is quiet a stretch. Where is the data? Where is the disclosure (n value) of the number of female respondents on either survey. Then the OCOM authors try to make a link that this is misleading the workforce data that has been done about the profession. Followed by another whopper of a stretch that the relationship that anyone (genderless data here) who graduated from OCOM and is still in practice (without defining what that means) is better off than the US Labor and Stats data on Entrepreneurship & US Economy is the BIGGEST stretch of all. The OCOM authors are trying to insinuate that there is a correlation between way too many topics in the form of reckless researchy-ness (let’s just start with basic research design and methodology issues) and then drop the “emerging trend” responsibility on a single gender. Really, if you think about it, women are OCOM budget balancers with their quarterly student loan deposits.

      6 likes
  • November 10 2012 at 11:14 AM
    Roppie writes:

    correlation does not imply causation

      4 likes
  • November 11 2012 at 1:34 PM
    monkeyacupunk writes:

    Wonder what they think of the most recent New Hampshire election results?  Bunch of ladies running the state and all:)

      3 likes
  • November 11 2012 at 7:21 PM
    bottley writes:

    What are the chances those ladies in New Hampshire will be “choosing” to work part time! grin

      3 likes
  • November 12 2012 at 11:43 PM
    racheline writes:

    After I had committed to about $100,000 in student loan debt, I found the Community Acupuncture Network now POCA.  I had done my research before going to school for this medicine.  I looked up the average salary on several websites and looked up the current research to know that acupuncture really works.  Also I was confident in the fact that NO educational institution would be actively crippling the future of their beloved profession with unmanageable debt.  I am so glad that I found the truth before I finished school and that I was able to learn a useful business model in the midst of all the lies I was fed before.  CAN was the only organization that told the realities of this business and that the student loans would never be paid off.  I went to school every day for two years after that wondering how the OCOM faculty and staff slept at night knowing that they were stealing my future.  Now I know.
    You guys look at the startling reality of this dream you are selling to bright young women who had bright futures and you come up with more candy-coated crap.  I will never own a house, I will never have a retirement fund, I will never feel financially secure enough to even think about children or a family.  I don’t appreciate seeing more of these lies put out for young women and I hope all of them find POCA and the truth before making the same profoundly crippling mistake that I did.
    OCOM, do the right thing and donate to POCA Tech.

      14 likes
  • November 13 2012 at 5:11 PM
    Skip writes:

    This is Lisa posting from Skip’s account. This email sent today to the authors of the article, OCOM Board of Trustees, and OCOM Title IX coordinator (that’s for nondiscrimination for women in education). I’ll keep you all apprised of responses:

    Dear members of the OCOM community,

    We were dismayed by the article “The Changing Demographics of Acupuncturists” in the recent edition of The American Acupuncturist. It is deeply insulting to every female graduate of OCOM who has struggled to support herself as an acupuncturist. That this article’s lead author is the Chief Financial Officer of OCOM suggests that OCOM, as an institution, has formally and publicly adopted a position that we, as alumnae, feel that we must formally and publicly protest.

    We represent the demographic—young female alumnae—that this article is attempting to scapegoat for acupuncture’s troubling workforce data. To suggest that many young, female acupuncturists simply choose to work part-time for personal reasons—when in fact there are scant opportunities for any graduate to do anything else—indicates that OCOM is unwilling to take responsibility for its role in so many graduates’ inability to support themselves with their practices. This article presents itself as research but is, in reality, a public relations maneuver; as such, it is part of an institutional pattern of misleading current and prospective students about the real-world value of their education.

    Furthermore, the article seems to be suggesting that, if acupuncturists’ compensation is disturbingly low in relationship to the cost and the length of their training, there is no cause for alarm because so many acupuncturists are women.  For OCOM to publicly embrace this position seems like a violation of at least the spirit, if not the letter, of the Title IX Educational Amendments.

    It is our student loans which have funded OCOM’s operations, including the salaries of the staff members who wrote this article. The enormous gap between what acupuncture education costs and what practitioners can expect to earn is continually balanced by means of OCOM students mortgaging their futures. Just because those students are increasingly young and female does not mean that OCOM is entitled to blithely shift its institutional responsibility onto their shoulders.  As alumnae, we refuse to condone this effort to do so.

    We request a formal retraction, an apology, and a meeting with the Board of Trustees to discuss our concerns.

    Sincerely,

    Allyson Abraham (class of 2009), Cortney Barber Hartman (class of 2008), Shauna McCuaig (class of 2009), and Lisa Rohleder (class of 1994)

      22 likes
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  • November 15 2012 at 11:26 PM
    kcasey44 writes:

    Lisa, how can you put a price on a “soul to soul connection” with your patients? Who needs a house, or food, or clothes when you’ve got that?

      6 likes
  • November 16 2012 at 2:36 PM
    spitfire writes:

    Ooohhh likin’ the letter!

      1 likes

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