Specific, Fearless, Positive
an artist's statement plus a reality check plus current events
So many people have said to me recently, “I love the art on your Substack — who’s the artist? And how did you find someone who would do that for you?” that I had to reconsider my usual response, which was: “A. Cohen is a pseudonym for an artist who prefers to remain anonymous. I didn’t recruit them, they offered on their own, sorry, that’s all I can tell you”. I asked A. Cohen if they would write an artist’s statement to provide some more context, and they graciously agreed. Here it is:
“The artist is a POCA Tech student. I autonomously saw a need for the creation of visual media that represents abstract concepts in the newsletter and fulfilled it — the field of acupuncture generally does not have much visual language beyond educational charts and the very few symbolic tools of our trade.
What I see most often in the field is generic photos and graphics that are sanitized of any personality, very boring and forgettable. I seek to make images that contribute to the field in a specific, fearless, positive, aesthetically opinionated way. Art should be memorable.
If you love it, please consider making a donation to POCA Tech to continue supporting our efforts in providing low cost acupuncture. This art is made for myself and the benefit of the organizations that I participate in— I do not grant permission to duplicate or use my art for your business or personal matters in any form.”
I applaud this statement! And I think “specific, fearless, positive” is a great description of the mindset we’re trying to cultivate at POCA Tech, both towards practicing acupuncture and towards small business. (Also “aesthetically opinionated”, but that’s a whole other post.)
When I started WCA, I had to make an internal shift from the mindset of my public health job — which was something like “please God don’t let the funding for my job disappear overnight” — to an entrepreneurial mindset, which was more like, “There’s a huge gap between what I see out in the world versus what I need and want for myself and my community. That particular gap is daunting but it also belongs to me — me specifically! It’s mine if I have the courage to claim it. It’s a space where I can build something positive.”
We hope that all the students in our program get the hang of identifying empty spaces and responding by creating something positive — something that they need for themselves, that their communities need too.
On the topic of what the world offers acupuncturists vs. what they have to build for themselves, I got an email from acupuncturist Amy Zahm DAOM in response to last week’s newsletter that I wanted to share with you:
I’ve been practicing for 20 years, and I’m so disheartened by the dysfunction of this profession. I won’t belabor you with the details of my entire journey (just a little of it). I’ll just say that I’ve worked primarily in private practice in a small rural community. I had great relationships with the local medical community, so when one of the clinics became a Federally Qualified Health Center, I had the opportunity to create an acupuncture program there. I had the ‘hospital’ job with salary and benefits. I also bought into the idea that the post-grad Doctor of Acupuncture and Oriental Medicine degree would bring me professional opportunities and advancement. (I know. Insert eye roll here). My Capstone project was a study of acupuncture within a rural FQHC, and I published it in the Journal of Alternative and Complementary Medicine.
I can absolutely confirm your belief that acupuncturists becoming Medicare providers is a pipe dream and, even if it were to happen, the idea that it would revolutionize or ‘save’ the profession, is absurd. When I see the idea that a hospital based acupuncturist would make $108K/year I laugh out loud. I was making slightly more than 1/3 of that amount (which included my benefits), for 40 hours/week. When I received my fancy degree, my salary increased by exactly zero, because it turns out I was only worth the net of what the clinic could bill for my services. And let me tell you, the administrative cost of billing Medicare is high.
I lasted 5 years and then returned to private practice. As you know, once you’ve worked for yourself, there’s a certain amount of risk that’s worth it in exchange for being in control of your schedule, your decision making, etc. And, because I’m willing to bill insurance and offer a fairly reasonable cash rate, I could make close to the same amount of money in a fraction of the time, which allows me to pick up contract work doing other things if I choose to. And if the Income Based Repayment program on student loans goes away, I’m done for.
I love acupuncture and Chinese medicine, and I’m so glad that you have created an opportunity for practitioners to learn this beautiful medicine without the crushing student loan debt.
Thank you, Amy, for the reality check.
Like a lot of other people in the US, I’ve been working on getting my head around the election and what it means for my world. A few people have asked me what I think it means for acupuncture education. At this point nobody knows for sure, so I can only tell you what possibilities seem likely:
It probably doesn’t mean anything good for acupuncturists trying to get their loans forgiven through Borrowers’ Defense to Repayment — that program could be wiped out by a Republican administration as part of a regulatory overhaul. In terms of Public Service Loan Forgiveness, that program can’t be abolished except by going through Congress, so it’s possible but it would take longer and it would be more difficult, since it’s popular. The traditional Income Based Repayment Program is in the same category as PSLF — it would have to be addressed through Congress and it’s popular, so it’s harder to get rid of, but Republicans might try.
It probably means that acupuncture schools who’ve been worried about Gainful Employment don’t have to worry as much — though it’s hard to say whether they can fully relax. There appears to be bipartisan support for addressing “financial value transparency”, which means letting students know how their education translates into future earnings before they sign on the dotted line. Since acupuncture schools have distinctively terrible debt to income ratios, they might not be off the hook even with a Republican administration — but who knows.
On a certain level it doesn’t change any of the dynamics underlying the acupocalypse. As Amy noted above, if Income Based Repayment goes away, a lot of acupuncturists are going to be in trouble. Student loans will remain a hot topic and prospective students are increasingly unwillingly to take them on. If they know that the party in control of the government is actively working on making it harder for anybody to get their loans forgiven under any circumstances, I can’t imagine that’s going to help acupuncture school enrollment. The business model for acupuncture education is broken regardless of who’s in power. I do wonder if the leaders of the acupuncture profession will continue to tout federal Medicare legislation as a solution to our problems, given that Republicans are not known for wanting to add benefits — but that legislation was never going to pass anyway so it doesn’t make much difference.
On the outer edges of possibility, the incoming administration has suggested getting rid of the federal Department of Education altogether. They also don’t approve of how accreditation currently works so they might try to take an axe to that too. This kind of transformation is much easier said than done, but it does open the door for all kinds of chaos for schools who have to comply with federal Department of Education requirements.
Because POCA Tech doesn’t take student loans, we’re not one of those schools — for which I’m particularly grateful right now. Chaos isn’t good for small businesses. And it seems to me that it’s more important than ever to invest in new models for acupuncture education, particularly ones that don’t depend on the federal government for support. I don’t know what’s going to happen next, but I promise that POCA Tech is committed to our “specific, fearless, positive” approach — no matter what.