The Changing Demographics

of Acupuncturists

By Susan A. Sloan, MBA; Jamie Reeves, BA; Abstract

Miles Sledd, LAc; and Jason Stein, LAc
Major demographic shifts in practitioner characteristics
of the acupuncture and Oriental medicine (AOM)
Susan A. Sloan, MBA is chief financial officer at the profession have occurred over the last fifteen years.
Oregon College of Oriental Medicine and a doctoral These changes may have far-reaching implications for
candidate in the School of Management of George Fox the continued development of the profession in terms
University. Her thesis project is the study of early practice
of practice economics, AOM teaching curriculums, and
experiences of new acupuncture graduates. Susan can
the adoption of AOM as part of the national health
be reached at [email protected].
care system. To date, these changes have received scant
consideration from researchers. Student demographic
Jamie Reeves, BA works in the Office of Planning and
Institutional Research of Oregon College of Oriental
trend analysis done at the Oregon College of Oriental
Medicine. Jamie can be reached at [email protected]. Medicine (OCOM), combined with graduate practice
survey results from 2007 and 2010, are consistent with
Miles Sledd, LAc is a licensed acupuncturist and directs and perhaps provide further insight into the 2008
both the clinical operations for the Oregon College of National Certification Commission for Acupuncture
Oriental Medicine and the college’s residency program. and Oriental Medicine Job Task Analysis (NCCAOM
Miles can be reached at [email protected]. JTA) study findings. In short, OCOM findings
show that, compared to a decade ago, those entering
Jason Stein, LAc is a licensed acupuncturist and chair of the profession today are younger and more likely
professional development at Oregon College of Oriental to be female. In addition, compared to their male
Medicine. Jason can be reached at [email protected].
counterparts, young female practitioners may be more
likely to work part-time by choice for an extended
period, and they report above-average satisfaction with
their professional practices.

Keywords: AOM profession, demographic trends, AOM workforce,

acupuncturists

12 T h e A m e r i c a n A c u p u n c t u r i s t Fall 2012
“Little research about the AOM profession itself has been undertaken, and little is
known about AOM professionals. As the data shows, understanding the changing
demographics of AOM practitioners is key to making sense of the disjointed
patchwork of research findings surrounding AOM practice economics.”

The acupuncture and Oriental medicine (AOM) profession is practice underperformance has yet to be undertaken. There is also
relatively new in the United States. Over the past 40 years it has no agreed upon measure of what constitutes economic success in
grown to over 20,000 or more licensed practitioners nationwide an AOM practice. Nevertheless, Stumpf and his colleagues infer
in 2012. There are, at present, vastly different estimates for the from the extant studies that the reason acupuncturists in the U.S.
actual number of acupuncturists in the United States with no single work fewer than full-time hours is that they cannot attract enough
source tracking both licensed and unlicensed practitioners.1 patients. Stumpf et al. assumes the situation is getting worse, signal-
Little research about the AOM profession itself has been ing dire consequences for the profession.9
undertaken, and little is known about AOM professionals. As the Stumpf et al.10 cited the 2008 National Certification
data shows, understanding the changing demographics of AOM Commission for Acupuncture and Oriental Medicine Job Task
practitioners is key to making sense of the disjointed patchwork of Analysis (NCCAOM JTA)11 for reported average hours worked and
research findings surrounding AOM practice economics. This has earnings, but he failed to differentiate between the very differ-
alarmed some, for example Stumpf, Hardy, Kendall & Carr, 2010,2 ent findings for different groups of respondents, relying instead
to the point of declaring the imminent demise of the profession. upon broad averages. In that study, 732 NCCAOM diplomates
Stumpf and his various colleagues assembled data from
3,4,5 nationwide responded to all or part of an online survey sent to all
multiple studies conducted in varied locations with widely differing 18,000 active diplomates (16% response rate). The survey found
objectives. These subjects and findings were discussed in an attempt that, overall, some 59% of responding NCCAOM diplomates were
to create a picture of the economic situations of the average practi- working 30 or fewer hours per week, and average income for 70%
tioner. The authors concluded that the cash-based private practice of the respondents was $60,000 or less.
model is “a failed business model,”6 and that “unemployment and Notwithstanding the rather low response rate of the study, these
underemployment among acupuncture program graduates is as statistics are most frequently seized upon as evidence that AOM
alarming as it is underreported.”7 Much of the support for this practitioners as a whole are not financially successful. However,
conclusion seems to be drawn from overreliance on broad averages the study also found there are groups of acupuncturists that are
imputed from a patchwork of studies and thus
may not provide a cohesive or comprehensive
basis for analysis of the profession. Another
limitation might be that the studies relied heav-
ily upon data drawn mostly from only two large, TM

urban population centers in coastal California.8

Two main questions arise: What demographic
trends are at work in the makeup of the profes-
sion? Do underlying shifts in these trends
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v 61 The American Acupuncturist 13
The Changing Demographics of Acupuncturists

far more economically successful and that there is a wide range of actual hours worked were generally fairly evenly distributed across
desired practice profiles that comprise the averages. Some of these categories and that the desired hours were skewed, unsurprisingly,
important findings have to date been given insufficient consider- toward the full-time categories.
ation in the literature or research. Accordingly, it is helpful to take What is surprising is that, as the report notes, 47.3% prefer to
a closer look at the findings if we are to understand some of the work less than full time, with 20.9% wanting fewer than half-time
nuances of how the profession is currently developing. hours. Another interesting dynamic is how preferred hours compare
In the 2008 NCCAOM JTA report, income was significantly to actual hours worked outside the middle of the distribution. On
correlated to hours worked per week and number of years in prac- the lower end of the preference scale, acupuncturists were actually
tice; those in the early years of practice realized lower incomes than working more hours per week than they wanted, and on the upper
longer-term practitioners who saw their incomes rise significantly, end of the scale, they were also working more hours than they
doubling on average by 11-15 years in practice.12 However, of those wanted. The gap where hours desired were less than actual hours
who responded to the survey, 301 (41%) indicated that they had worked occurred in the middle of the distribution, between 21 and
been certified within the past 1-5 years. Therefore, it may be that 40 hours per week. The placement of this gap in the distribution
the very significant proportion of respondents in their early years of and its causes are not yet understood, indicating an important area
practice may have caused the overall financial success estimation of for further research.
the AOM population to be significantly understated compared to Since income is largely a function of hours worked, the average
Stumpf and his colleagues’ findings. income level of all acupuncturists will show the impact of the large
Perhaps the most interesting findings from the 2008 NCCAOM part-time workforce (especially those working fewer than 10 hours
JTA—at least in terms of understanding the economic perfor- per week). However, this income statistic does not support the
mance of acupuncturists—are summarized in Graph 11: Practice notion that these practitioners are, on average, failing to achieve
Characteristics of Diplomate Respondents: Hours Worked per their ideal practice hours or that the private practice model is to
Week as an AOM Practitioner Compared to the Preferred Hours of blame. When we consider that some 41% of the survey respondents
Work per Week.13 were only 1-5 years into their careers, it is less surprising that many
aiming for full-time work have yet to achieve their desired poten-
Figure 1. Practice Characteristics of Diplomate Respondents:
tial. Indeed, this may have more to do with the start-up process
Hours Worked per Week as an AOM Practitioner Compared to
(see especially Gartner et al.14 and Petrova15 among many scholars
the Preferred Hours of Work per Week
writing on this phenomenon) and the business learning curve than
some general failure of the profession. Further research is again
needed to understand what dynamics are at work in the preferences
of AOM professionals at all ranges of the work hours distribution.
Given the limits of previous studies and the unanswered ques-
tions about the large percentage of practitioners preferring to work
part-time, inferences and conclusions about the general failure
of the private practice model seem premature, and any alarmist
rhetoric used to describe the state of the acupuncture profession
seems unwarranted. However, if these worries about the unsustain-
ability of the private practice model are correct, then other studies
of practicing acupuncturists should support those conclusions. In
actual fact, there is potential that hypothesized negative economic
outcomes could be amplified due to the recent economic downturn.
While the acupuncturist community has not engaged in any kind
Graph 11: Practice Characteristics of Diplomate Respondents: Hours Worked
of large-scale standardized research that would settle this question
per Week as an AOM Practitioner Compared to the Preferred Hours of Work
per Week. In: Ward-Cook K, Hahn T. NCCAOM 2008 job task analysis: A profession-wide, graduate demographics and outcomes data from
report to the acupuncture and oriental medicine community. Jacksonville, the Oregon College of Oriental Medicine (OCOM) offers further
FL: National Center for Certification of Acupuncture and Oriental Medicine; insight into recent trends in one segment of the AOM profession.
2010. Used by permission of the NCCAOM ©2010.
Oregon College of Oriental Medicine’s Outcomes
The comparative graphs depicting the difference in actual hours
worked for a category of AOM practitioner versus his or her The Oregon College of Oriental Medicine, widely regarded as a
preferred number of hours clearly shows that there are multiple leading non-profit, single purpose AOM graduate institution, has
ideal desired practice profiles for acupuncturists—not all acupunc- graduated over 1,100 Master’s and doctoral graduates in its 29-year
turists wish to work a 40 hour week. A quick glance shows that the history. The school awards 65-70 Master’s and 15-18 DAOM

14 T h e A m e r i c a n A c u p u n c t u r i s t Fall 2012
The Changing Demographics of Acupuncturists

degrees per year on average. While it is but one of the fifty or For comparison, the reported persistence rates for each sampled
so AOM institutions nationwide according to the Accreditation cohort from the time of each cohort’s licensure to 2010 was then
Commission for Acupuncture and Oriental Medicine (the accredit- plotted to show how many have survived as a percentage of the
ing body for AOM institutions of higher learning, www.acaom.org/ cohort’s original number. As might be expected, there are cohort
find-a-school/), its graduates’ experiences cannot be generalized to variations in persistence rates, but overall, OCOM graduates’ prac-
represent the whole AOM profession. tices seem to survive at rates substantially above the national average
OCOM has collected graduate practice data for multiple cohorts for small businesses. While cross-profession studies are lacking
that can be added to the set of surveys of practitioner outcomes and cannot provide a basis of comparison with the persistence of
informing this discussion. In OCOM’s 2007 and 2010 graduate other professionals in their chosen professions, it seems premature
surveys, graduate practitioners having 3, 5, 7, 9, and 13 years in to declare that acupuncturists are somehow less likely to persist in
practice in many different locations in the U.S. and overseas were their profession than other professionals.
examined, thus overcoming a limitation of the California studies Figure 2. Comparison of Persistence Rates
arising from concentration on practitioners in only two selected Percentage Business Survival Over Time:
major urban areas.16,17 In both of these OCOM graduate studies,
OCOM Grads vs. All U.S. Small Businesses
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).
While there are many areas in the data collected where com-
parisons could be drawn to other studies to date, three outcome
measures seem to be especially important to both the graduates and
AOM schools: (1) percentage of graduate persistence in the profes-
sion; (2) whether work is full time; and (3) annual income from
practice. All three outcomes speak to the viability of the profession
over time and to the financial welfare of practitioners. When we
summarize the OCOM findings and compare to the findings of
Stumpf, Hardy, Kendall and Carr,18 we see some stark divergences
in these three common measures. A fourth measure, practice
satisfaction, suggests that not all is “gloom and doom.”

Persistence in the Profession.

U.S. Bureau of Labor Statistics, Entrepreneurship and the US Economy,21
Whereas Stumpf opined that the chances for success of an acu- accessed at http://www.bls.gov/bdm/entrepreneurship/bdm_chart3.htm;
puncturist in this profession are “no better than flipping a coin,”19 and, Chapman T. 2007 Graduate survey: Summary of results. Portland
OCOM’s 2007 and 2010 surveys of graduate cohorts 1994-2010 (OR): Oregon College of Oriental Medicine; 2008; and, Reeves J, Stump
S, Chapman T. 2010 Graduate survey: Summary of findings. Portland (OR):
found that, respectively, 91% in 2007 and 88% in 2010 were Oregon College of Oriental Medicine, Office of Institutional Research; 2010.)
actively in practice in 2012. Furthermore, analysis of individual
cohorts showed surprising consistency of persistence across all
Hours and Annual Practice Income
graduate cohorts regardless of length of time in the profession.
Figure 2 compares OCOM graduates’ average practice survival rates Most studies22 equate economic performance with practice suc-
in years after licensure versus the survival rates of all U.S. small cess as measured by full-time work hours and an inferred level
businesses over time.20 In this graph, we followed the U.S. Bureau of income generation based on an hourly fee rate. (This method
of Labor Statistics’ methodology for tracking the average survival of annual income approximation was also used in the 2008
rate trend for all U.S. small businesses. NCCAOM JTA.23) Following this procedure, the analysis of

“While there are many areas in the data collected where comparisons could be drawn
to other studies to date, three outcome measures seem to be especially important to
both the graduates and AOM schools: (1) percentage of graduate persistence in the
profession; (2) whether work is full time; and (3) annual income from practice.”

v 61 The American Acupuncturist 15

The Changing Demographics of Acupuncturists “While income, hours worked and rates
charged might seem somewhat low in
relation to what education level and
previous studies taken together led Stumpf and his colleagues to expectations for professionals in general
infer that fewer than half of acupuncturists are working full time,
and half are making less than $50,000 per year.24 By contrast,
society might dictate, we do not see
survey results from OCOM’s 2007 and 2010 multiple-cohort concomitant dissatisfaction among
surveys indicate that 61% and 62% of graduates, respectively, work OCOM’s graduate practitioners.”
full time and have significantly higher estimated annual incomes.
Estimated annual income for full time, part time and all respon-
dents is shown in Table 1. ideal practice volume. In 2010’s survey, results were substantially
the same for overall satisfaction and improved (80%) levels of
Table 1. OCOM Estimated Income Averages ideal practice volume (with 27% achieving 100% or more of ideal
volume) despite recessionary conditions.
Group Average 2007 2010
OCOM’s surveys do not specifically break out fulltime and
Part-time $33,200 $ 30,732 part-time practice in these data. Future surveys may provide further
Full-time $72,268 $105,829 insight into whether there are any significant differences in practice
satisfaction or ideal practice volume between full-time and part-
All responses $61,613 $ 82,291
time practitioners. However, it seems that a significant portion of
part-time practitioners are reporting high levels of satisfaction with
In these comparisons, full-time status is defined as working at levels of practice volume and their practices in general.
least 32 hours per week for 46 weeks per year. (This definition While income, hours worked and rates charged might seem
is comparable to the definition of “full-time” used in U.S. Small somewhat low in relation to what education level and expectations
Business Administration studies, although fewer hours than for professionals in general society might dictate, we do not see
used in some workforce studies.) In OCOM studies there were concomitant dissatisfaction among OCOM’s graduate practitio-
no clear differences in the percentage of respondents reporting ners. This seemingly contradictory finding can most reasonably be
full-time practice between older and newer cohorts except for a explained by the changing demographics of these practitioners as
lower percentage (57%) of full-time work for those in practice shown.
fewer than five years. This is most likely an effect of the start-up
process as noted by Petrova,25 since 70% of those in practice five The Changing Demographics of OCOM’s Graduates
years and 87% of those in practice six years reported working full Consistent with the 2008 NCCAOM JTA27 findings that some
time. Rather surprisingly, except for the part-time contingent, the 70% of AOM practitioner respondents were female, OCOM
2010 Survey’s economic results were actually improved over 200726 graduates have followed an unmistakable pattern over the 29
despite the severe recession that occurred in the same time period. years of the institution’s history as its graduating cohorts to trend
younger and more female as a percentage of the whole. (See Table
Satisfaction: A Missing Measure 2, Figure 3, & Figure 4.) As the data show, the 1990 cohort was
To be sure, hours worked and annual income are important nearing 40 years of age and was split fairly evenly between male and
measures of practice success, but they are by no means the only female (53% male and 47% female.) By contrast, OCOM’s 2010
important measures. Satisfaction with one’s professional practice cohort was overwhelmingly female (87.8%), averaging age 31.8. By
serves as an important counterweight to purely quantitative mea- way of comparison, another AOM institution, Tai Sophia Institute,
sures of hours, rates, and annual income. For example, if hours and located on the East coast, reported in 2011 that their student body
income are high but satisfaction is low, practitioners may be more was 84% female.28
likely to leave the profession despite economic success. Thus, if Assuming that OCOM’s graduates are not significantly differ-
satisfaction erodes, we might expect to see more long-term attrition ent than the population at large, the decision of large numbers
(e.g., closed practices) even if they are economically viable. of female graduates in their early 30s to work part time should
To address this missing metric, OCOM’s graduate survey asks not be a mystery if we consider insights from studies of women’s
graduates about their levels of satisfaction with their practices—spe- employment and work patterns in general. According to the Pew
cifically the percent of ideal practice volume and general satisfaction Research Trust’s recent study of American motherhood demograph-
level with their practices as measured on a five-point Likert scale. ics29 American women are waiting longer (until their late 20s on
OCOM’s 2007 and 2010 surveys both showed high levels of average) to start families. Looking closer, the long-term trended
satisfaction with graduates’ practices—even those that were clearly average age of initial childbirth is increasing, with the largest
part-time endeavors. For example, the 2007 survey found that percentage increases occurring in the 30+ age group. The study also
53% of respondents were “very” or “extremely” satisfied with their found that increased education level tended to delay childbirth.
practices and only 17% less than “moderately satisfied.” On aver- Taken together, these demographic clues indicate that the majority
age, graduates said they were treating 70% of their ideal practice of today’s AOM graduates are ready to enter their profession at the
volume, and 25% said that they were seeing 100% or more of their same time they are most likely to be raising families.

16 T h e A m e r i c a n A c u p u n c t u r i s t Fall 2012
The Changing Demographics of Acupuncturists

Table 2. Demographic Data for Selected Graduate Cohorts, Figure 4. Mean Age at Graduation Trend 1991-2010
1986-2010 Graduate Cohort Demographic Analysis,
1986 – 2010 (Selected Representative Cohorts)

Entire Annual Cohort

Grad Cohort Total % of Mean Std Median

Grads Total Age at Dev Age at
Grad Grad

1986-1990 55 100% NA NA NA

1991 15 100% 37.93 6.60 37.93

1999 44 100% 37.21 9.84 38.00

2004 54 100% 37.59 9.19 36.00

2009 79 100% 35.59 8.39 33.00

2010 68 100% 32.38 5.92 32.00

Male Graduates

1986-1990 23 41.8% NA NA NA The question then arises as to whether the average new graduate
1991 8 53.3% 37.00 6.63 37.00 AOM practitioner—a female in her early 30s, probably with chil-
dren—is normal in terms of other self-employed worker patterns.
1999 18 40.9% 37.21 9.84 38.00 The U.S. Small Business Administration’s study of self-employed
2004 21 38.9% 38.48 9.15 38.00 women and time use30 sheds additional light on the dynamics of
self-employment for this general population demographic, and
2009 20 25.3% 33.35 6.62 31.50
it might provide some insight into the practice profiles for new
2010 9 13% 31.67 2.50 32.00 acupuncture graduates. The study stresses that the time use of self-
Female Graduates employed females is very different from that of self-employed males
and from wage earners of both genders, primarily due to child care
1986-1990 32 58.2% NA NA NA
considerations.31
1991 7 46.7% 39.00 6.90 39.00 The SBA study showed that self-employed women in all indus-
1999 26 59.1% 37.42 8.34 39.00 try classifications worked fewer hours on average (approximately
6.2 hours per day) on work-related activities, compared to 7.6
2004 33 61.1% 37.03 9.31 35.00
hours for self-employed men, while wage-earners of both genders
2009 59 74.7% 36.36 8.83 33.00 worked more than their self-employed counterparts. Further, this
study strengthened the contention that self-employed women’s
2010 47 86.8% 32.55 2.50 32.00
sensitivity to lifestyle factors increased with education level. From
Note: Data regarding age at graduation was not available for the 1986-1990 cohorts. this research, Master’s level self-employed female AOM practitio-
ners might be normal in their hours worked and time use, as well
Figure 3. Male/Female Percentage of Student Body Trend, as subject to the same lifestyle drivers as the general population.
1986-2010 However, specific research will be needed to confirm these infer-
ences and discover any points of significant variance.
As for self-employed men, Tuttle32 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 Hahn33 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.

v 61 The American Acupuncturist 17

The Changing Demographics of Acupuncturists

It is doubtful whether demographics can fully explain the large If the trend to a younger, female-dominated profession con-
percentage of AOM practitioners who work part time, in spite of tinues, there may be significant implications for the individual,
the circumstantial evidence presented. For example, we have not dif- the institutions that prepare them, and the profession as a whole.
ferentiated between those who are temporary part-time practitioners Further research into these demographic shifts and the reasons a
and those who choose part-time work as a longer-term strategy of five large percentage of practitioners are choosing part-time work will be
or more years. Most global studies considering patterns of part-time instrumental in helping the profession, institutions, and individuals
entrepreneurship view it as a practical interim strategy to tide over prepare for and adapt to the changes in a positive way.
an entrepreneur until the new business generates sufficient profits to
enable her/him to quit paid employment (e.g., Petrova34). Indeed, Disclosure of Conflict of Interest and Financial Disclosure:
recent cross-national studies show 80% of part-time entrepreneurs fit
The authors are employed by Oregon College of Oriental Medicine.
this pattern (Minniti,35 Bosma36).
There are no financial or conflicts of interest to disclose.
Some part-time AOM practitioners may be temporarily devoting
part-time hours to their nascent practices while working at other
employment (such as working at multiple clinics or work in another References
field) until the practice volume sustains full-time work, while still 1. One source often referred to is the Aculocator Map: Customer Mailing Labels by State and
others may be intending a more long-term part-time strategy. As we Zip Code [Internet]. Santa Ana (CA): MPA Media [cited 2012 June 15]. Available from: http://
www.acupuncturetoday.com/list/info/aculocatorzip.
have shown, there is good reason to believe that those who choose
2. Stumpf S, Hardy M, Kendall D, Carr C. Unveiling the United States Acupuncture
part-time work due to lifestyle and family considerations may intend Workforce. Complementary Health Practice Review. 2010;15(1):31-9.
to do so for a much longer period and without engaging in secondary 3. Stumpf [SH]. Acupuncturist under-employment and unemployment [Internet]. Simsbury
employment. Until further research is conducted, we are unable to (CT): National Guild of Acupuncture and Oriental Medicine; 2008 December [cited 2011 Jan
assess the percentage of part-time AOM practitioners fitting into 29]. Available from: www.ngaom.org/wp-content/uploads/2011/10/ Acupuncture Workforce.pdf.

either part-time category. In any case, the AOM workforce is clearly 4. Stumpf et al., op. cit., 2010, p. 32

not a monolith, and detailed study of the various segments should 5. Stumpf S, Carr C, McCuaig S, Shapiro S. The U.S. acupuncture workforce: The economics of
practice. The American Acupuncturist. Summer 2011;56:30-4.
be more useful to understanding the trends than focusing on broad
6. Stumpf et al., op. cit., 2008.
averages.
7. Stumpf et al., op. cit., 2010, p. 32

Other Factors Affecting Hours 8. Dower C. Acupuncture in California [Internet]. San Francisco (CA): University of California
at San Francisco Center for the Health Professions; 2003 [cited 2011 Jan 15]. Available from:
Besides demographic changes, social and cultural changes may also www.calendow.org/uploadedFiles/accupuncture_in_ca.pdf
have a role in explaining the state of the AOM profession in a way 9. Stumpf et al., op. cit., 2011.
that is largely unrecognized by researchers to date. A case in point 10. Stumpf et al., op. cit., 2010, and Stumpf, et al., op cit., 2011.
is the ancient Confucian and Taoist values at the heart of AOM’s 11. Ward-Cook K, Hahn T. NCCAOM 2008 job task analysis: A report to the acupuncture and
healing approach, which stress balance and harmony in life.37 Many oriental medicine (AOM) community. Jacksonville, FL: National Certification Commission for
Acupuncture and Oriental Medicine; 2010.
younger, highly-educated female acupuncturists, steeped in this
12. ibid., p. 19
philosophy as part of their professional training, may be taking this
13. ibid., p. 23
teaching to heart, choosing to order their work lives to fit their values
14. Gartner W, Shaver K, Carter N, Reynolds P, editors. Handbook of entrepreneurial dynamics.
instead of merely maximizing their pursuit of economic gain. The process of business creation. Thousand Oaks: Sage; 2004.
While specific research is needed to confirm this theory, it may 15. Petrova K. Part-time entrepreneurship and financial constraints: evidence from the Panel
be that one of the reasons for the reported high satisfaction levels Study of Entrepreneurial Dynamics. Small Business Economics [Internet]. 2010 Dec 29 [cited
2011 Dec 20]. Available from: http://www.springerlink.com/content/qr43570771k30338/
of graduates in recent years could be the opportunity to work part fulltext.pdf.
time in a flexible self-employment setting that honors the balance 16. Chapman T. 2007 Graduate survey: Summary of results. Portland (OR): Oregon College of
of work and family life. If that is so, outcome measures of practice Oriental Medicine; 2008.
success may have to be significantly reoriented toward quality of life 17. Reeves J, Stump S, Chapman T. 2010 Graduate survey: Summary of findings. Portland
measures and away from purely economic outcomes, student loan (OR): Oregon College of Oriental Medicine, Office of Institutional Research; 2010.

debt repayment trends notwithstanding. 18. Stumpf et al., op. cit., 2010.
19. Stumpf, op. cit., 2008.
Summary and Conclusions 20. SBA Office of Advocacy. Annual Report of the Office of Economic Research FY 2011.
Washington, D.C.: U.S. Small Business Administration, Office of Advocacy; December 2011.
We have considered here some of the concerns expressed in recent
21. Table 3: US Small Business Survival Rates Over Time. U.S. Bureau of Labor Statistics,
literature about the long-term viability of the AOM profession and Entrepreneurship and the US Economy, accessed at http://www.bls.gov/bdm/entrepreneurship/
have shown how demographic trend factors may explain some of the bdm_chart3.htm.
dynamics at work. We have argued that focusing on broad averages 22. Stumpf and Dower are two cases in point, but the assumption that economics drives success
in hours worked or annual earnings is misleading and unhelpful in measures is widespread in the literature to date.

understanding the underlying trends, especially regarding the increas- 23. Ward-Cook and Hahn, op cit., 2010.

ing percentage of AOM practitioners that may be working part time 24. Stumpf, et al., op. cit., 2011.

due to choice rather than necessity and still reporting a high level of 25. Petrova, op. cit., 2010.

satisfaction with these part-time practices. continued on page 42

18 T h e A m e r i c a n A c u p u n c t u r i s t Fall 2012
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INDEX TO ADVERTISERS Golden Flower Trading Co. 13

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ActiveHerb Technologies, Inc. 43
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AOMA - Austin 28
Lhasa Medical Inc. Back Cover
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American Acupuncture Council 44
Mayway 2
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Blue Poppy 44
Seirin America Inside Back Cover
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Five Branches University 4
Pacific Symposium 21
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Golden Flower Chinese Herbs 37
The Career Connection 39
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Interview with Niki H. Bilton continued from page 11 The Changing Demographics of Acupuncturists continued from page 18

KR: Continuing along this amazing path, do you have plans for 26. Reeves, Stump & Chapman, op. cit., 2010.
future teaching now? 27. Ward-Cook & Hahn, op. cit., 2010.
28. Tai Sophia Institute. Student demographics [Internet]. Laurel (MD): Tai Sophia Institute;
NB: Reflecting on my life as I approach my 60s, everything I’ve been 2011 Nov 16 [cited 2012 Jan 4]. Available from: http://taisophia.com/NPStudentDemographic.
doing can really be summed up as “peripatetic gardening.” I know aspx.
a little bit about the sun and moon, clouds and rain, the movement 29. Cohn D, Livingston G. The New Demography of American Motherhood [Internet].
of zheng and xie qi and the essential nature of different living beings. Washington (DC): Pew Research Center; 2010 [cited 2012 Mar 20]. Available from: http://
www.pewsocialtrends.org/files/2010/10/754-new-demography-of-motherhood.pdf.
So I putter about talking with the plants (otherwise called patients
30. Gurley-Calvez T, Harper K, Biehl A. Self-Employed Women and Time Use [Internet].
or students), delighting in their individual beauty. I focus on being [Washington (DC)]: U.S. Small Business Administration, Office of Advocacy; 2009 Feb.
able to access a little bit more of whatever they need at any moment Contract no. SBA HQ-07-M-0409. Available from: www.archive.sba.gov/advo/research/
in time from the elements to support their generating, expanding, rs341tot.pdf. Link should be: http://archive.sba.gov/advo/research/rs341tot.pdf

stabilizing, retracting, and conserving impulses as they go through 31. ibid., p. 15

the seasons of their lives. 32. Tuttle R. Self-employment, work-family fit and life satisfaction among male workers
[Internet]. Annual Conference of the American Sociological Association; 2005 Aug 16;
I have no illusions that I can heal or teach; all I can do is offer Philadephia; 1-17 [cited 2012 June 15]. Available from: SocInfo database or [email protected].
opportunities for living and learning, and trusting Nature. How 33. Ward-Cook & Hahn, op. cit., 2010.
could I ever turn away from this path? I love this stuff! I’m commit- 34. Petrova, op. cit., 2010.
ted to keeping on trucking, and basically I’ll go wherever there are
35. Minniti M, Bygrave WD, Autio E. Global Entrepreneurship Monitor, 2005 Executive Report.
patients and undergraduate or graduate students wanting to apply Babson Park (MA): Babson College and London Business School; 2006, p. 32-4.
the Dao, which is also the art of medicine, to their own lives and to 36. Bosma N, Harding R. Global Entrepreneurship Monitor, GEM 2006 Summary Results.
their wider communities. Babson Park (MA): Babson College and London Business School; 2007, p. 20-1.
The next CSOE Carnival will be held in the first week of May, 37. See Fan X. The Chinese cultural system: Implications for cross-cultural management. SAM
Advanced Management Journal. 1995;60(1):7.
2013, in the Oakland, California, area. For details about a CSOE
Carnival near you, and other CEU/PDA offerings, please contact
Julie Lawson, College Principal: [email protected]. We love Acknowledgement:
receiving requests for specific conference, seminar, workshop, or
We wish to acknowledge the support and advising we received from
clinical events.
Dr. Tim Chapman, PhD, vice president for academic affairs and chief
Karen, thank you so much for hanging out with me!
academic officer at the Oregon College of Oriental Medicine. His
KR: You are most welcome, and thank you for your generous sharing excellent graduate surveys provided the impetus for this article.
of knowledge and skill set with so many patients and practitioners!
42 T h e A m e r i c a n A c u p u n c t u r i s t Fall 2012
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