Strategic Workforce Development: The Key to Our Professional Survival

By Bill Reddy, LAc, Dipl. Ac.

In a recent discussion with Mina Larson, CEO of the NCCAOM, we discussed a number of issues that are challenging the acupuncture and herbal medicine (AHM) profession: from technique appropriation (LMTs performing cupping, DCs offering "Graston," PTs adding "dry needling") to dwindling enrollment in acupuncture schools nationwide. Every profession has a clearly defined "pipeline" of new professionals in their career field ... except us.

We need to focus on strategic workforce development so we can meet the rising demand for our services across the nation. Let's quickly cover what strategic workforce development looks like, how our national organizations can come together to produce a plan, and how we can assist at a state and local level.

What Strategic Workforce Development Looks Like

An analysis usually starts with a "current state assessment." It would answer questions such as:

  • What is the current status of enrollment into our educational system?
  • What are the attrition rates through retirement and changing careers?
  • How are we distributed across the country, part time / full time, private practice vs. group practice vs. hospital-based practice, income levels?
  • What are our critical roles and skill sets, and where are our new students coming from?

workforce - Copyright – Stock Photo / Register Mark From this point, the analysis would shift to future state visioning/scenario planning. Questions would include:

  • What's the potential future demand? (looking at extremes from minimum to maximum)
  • Where are there new markets for potential expansion? [VA / DoD and hospital hiring, as well as Federally Qualified Health Centers (FQHCs), direct patient care, etc.]
  • How are we preparing our students to work in an integrative setting (hospitals, VA / DoD, clinics) to ensure greater access to all patients?

A "skills gap analysis" would then be performed, whereby we may need to update or replace our competencies. The NCCAOM performs a Job Task Analysis every five years to make sure what's being measured on its examinations is pertinent to real-world practice.

Finally, there would be an implementation phase, followed by measuring certain metrics and adjusting if necessary. For instance, the U.S. Department of Health and Human Services (HHS) put together an 81-page Health Workforce Strategic Plan 2021 consisting of four goals, further broken down into 12 objectives. The four goals are as follows:

  1. Expand the health workforce supply to meet evolving community needs.
  2. Improve the distribution of the health workforce to reduce shortages.
  3. Enhance health care quality through professional development, collaboration and evidence-informed practice.
  4. Develop and apply data and evidence to strengthen the health workforce.

We've Made Great Progress – But How do We Sustain It?

There have been a number of workforce analyses performed through national survey tools in the past few decades;1-5 and the American Society of Acupuncturists recently published a 32-page overview titled 2021 State of the Profession Report: Achieving Whole Person Care in the American Healthcare System."6 It succinctly covers where we are and some of our recent victories [getting a Bureau of Labor Statistics "Standard of Occupational code," CMS covering chronic low back pain through Medicare, the Veterans Health Administration directive to include acupuncture as part of the provision of complementary and integrative health services, and representative Judy Chu (D-Calif.) introducing the 2021 Acupuncture for Seniors Act]. However, it doesn't address how we can bolster our profession for future demand.

National organizations such as the NCCAOM, CCAHM and ASA have ongoing conversations on promoting the profession, from advancing greater insurance coverage (including Medicaid on a state level) to providing more hiring opportunities for new graduates. There may be ways to easily and realistically leverage the resources of these groups to also focus on workforce development.

An Action Plan to Consider

We could bolster the dissemination of information to many groups through the creation of basic PowerPoint presentations for career fairs for local acupuncturists and professors who work at the acupuncture schools. The NCCAOM may be able to offer incentives such as PDA points for taking the initiative to present at high-school career days. The CCAHM could commit to teaching advocacy in every curriculum, and the importance of state association membership, thereby strengthening the national association.

Bastyr University (offering programs in acupuncture, traditional Asian medicine, naturopathy, nutrition, ayurvedic medicine, psychology and midwifery) has a strategic plan that includes "attracting, supporting and retaining exceptional students representing diverse cultures, races/ethnicities, life experiences and perspectives" and "developing and supporting a coordinated recruitment, marketing and public relations campaign to attract future leaders in the natural health arts and sciences." The challenge is translating these visions to successful actions.

To help each school, we have to do this on a national level, starting with coordinated resources on presenting at local high-school career fairs. Recruiting can also be at a university level, where the students have completed their pre-med or basic science/biology degrees and are looking for the next steps.

Enrollment is down across the board, not just in acupuncture programs, and we must be proactive to create an attractive profession that's both lucrative and personally gratifying for the next generation of AHM professionals.

References

  1. Stumpf SH, Carr CR, et al. The U.S. acupuncture workforce: the economics of practice. Am Acupuncturist, 2012;56:30-34, 40.
  2. Ward-Cook K., Reddy B, Mist S., A snapshot of the AOM profession, 2014-2016. Meridians J Acu Oriental Med, Fall 2017;4(4).
  3. Stumpf SH, Ward-Cook K, Carr CR. Comparing outcomes from the two most recognized acupuncturist workforce surveys. J Integr Med, 2017 Jan;15(1):37-43.
  4. Burke A, Upchurch DM, Dye C, Chyu L. Acupuncture use in the United States: findings from the National Health Interview Survey. J Alt Compl Med, 2006;12:639-648.
  5. Stumpf SH, Hardy ML, Kendall DE, Carr CR. Unveiling the United States acupuncture workforce. Compl Health Prac Rev, 2010;15(1):31-39.
  6. 2021 State of the Profession Report: Achieving Whole Person Care in the American Healthcare System. American Society of Acupuncturists. www.asacu.org/wp-content/uploads/ASA-Workforce-Report-02-Sept-Final.pdf

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