House of Cards
on false narratives, predatory schools and (not) transforming healthcare, part three
Previous posts in this series by Amelia Zahm, DAOM are about becoming disillusioned with the acupuncture profession; see Part One and Part Two. If anyone’s been wondering about some of the quirky aspects of POCA Tech, like why we encourage students to think twice about whether they want to go to acupuncture school, why we offer a certificate rather than a degree, and above all why our tuition is so low compared to others, I hope this series clears all that up. Big thanks again to Amy for providing this important context.
Her story continues:
I think, for me, the big lie is that we have to keep striving toward some ever-larger thing in order to be worthy of what we’re doing, in order for acupuncture to be worthy of the title ‘medical service’. We can’t just be helping people feel better, we have to be transforming healthcare. We can’t just have a masters degree, we need a first professional doctorate, and then a clinical doctorate and then a specialization in X, Y, and Z. We can’t just be part of the medical care people receive, we have to revolutionize it.
Every week I get an email from someone inviting acupuncturists to a specialized training to get another credential, another certification, another mentorship for only a few thousand dollars on top of the hundreds of thousands of dollars most licensed acupuncturists have already spent on their foundational education. When are we enough? How much money do we have to spend to be able to make a living? How much debt do we have to drown under to be legitimate?
I’m always going to want to learn more and read more and study more, because I’m insatiably curious. One of the reasons acupuncture and Chinese medicine is such a good fit for me is that there’s always something new to explore. But that’s not what makes me a good practitioner.
My patients have taught me that my presence and my attention are the most important things. A good understanding of the body and a few carefully placed needles also help. I wonder, does this ‘transforming healthcare’ narrative teach us that our voices are more important than those of our patients?
I recently did a trade with an acupuncturist who moved to town. It was, without question, the worst acupuncture experience I’ve ever had. There were multiple reasons for my discomfort, but what stands out is this practitioner telling me he was also a health coach, so he would be setting some goals for me and following up to make sure I was on track with them. At the end of the session he outlined these goals and texted them to me. A week later he sent a text to ask about my progress. Here’s the thing — he didn’t ask if I wanted coaching. He didn’t ask what my goals or ideas about solutions to my ‘issues’ were. (I really just wanted some relief from my neck pain, which I didn’t get.) There was no informed consent. There was no consent at all. Not to use an over-used word, but it was offensive. And this practitioner spent years teaching in an acupuncture school and now provides business coaching for other acupuncturists at premium rates.
The narrative about our power as practitioners runs deep. When did ‘transforming healthcare’ become having authority over other people’s bodies?
A lot of what I’ve written above coalesced as I worked through the Borrower Defense application.1 I recommend every acupuncturist complete it and find and read supporting documentation, even if they never submit. When I first joined the acupuncturists’ Borrower Defense Facebook group, I decided to submit even though it seemed like a long shot. A few hours of my time was worth the slimmest possibility of relief.
As I started the process, here are the internal narratives I held about my student loan debt: 1) I’ve always been irresponsible with money, and this amount of debt is just more proof of that. What was I thinking? 2) I’m just bad at business and too lazy to do enough marketing. 3) If only I’d tried harder, I could have built a business that would allow me to pay off these loans. I should be able to generate $100K if I could just get it together. 4) I’m embarrassed and ashamed to talk about the situation that I’m in.
As I worked through the application, I gathered my supporting evidence. I looked at the Bureau of Labor Statistics numbers on acupuncture jobs and salary levels. I read the OPB articles about high debt to income ratios for acupuncturists. I looked at The HEA Group’s report (“Some Graduate Schools Never Pay Off”) and found acupuncture schools located prominently on the list. I went back through OCOM’s website and reflected on conversations with admissions staff. I thought about what I’d been promised and compared it to what I’d received. Most importantly, I read posts from other acupuncturists, most of whom were drowning in student loan debt, many of whom had given up or were about to give up on practice. I read posts from other acupuncturists who chose to shame everyone in the group for their collective failure and desire for debt relief.
The most striking stories were from people who had been told by financial aid administrators that no one ever defaults on their acupuncture student loans because of income based repayment plans. Many of these people had also been encouraged to go from a Masters program straight into a Doctoral program. Some had loans in excess of $500,000.
The reality of the predatory nature of all these schools hit hard. The realization that, had I really understood the nature of these loans and the long-term consequences of this debt, I may have made very different choices, was sobering. And most importantly, I realized that I wasn’t stupid or foolish or lazy, and that I most certainly wasn’t alone.
This practice of acupuncture has given me so much. And I’ll be working until I die, that is if I can continue to maintain a license to practice. If the income based repayment programs disappear, I will be financially devastated. I feel heartbroken, disappointed, betrayed, scared, angry. And every day, I go to my office, work with my patients and feel grateful for the work I do. Our profession has built itself on a house of cards and, as the foundation collapses, I wonder where we’ll all land.
Borrower Defense is a form of federal student loan discharge for people who took out student loans based on misleading information or other misconduct by schools. Hundreds of acupuncturists have applied.