hi there, i have a career question. i'm currently in graduate school for traditional chinese medicine. one earns an m.s., and then can sit for state/national board exams for a license to practice (the l.ac). after that, people typically go into private practice or join a pre-existing practice, or work at a hospital (this last category is pretty rare, but may be growing?)
we do at least 960 hours of clinical training during the 3.5 years it takes to earn the degree. this involves working in student clinics under clinical supervision, seeing patients at progressively higher levels of autonomy. we use various acupuncture techniques and chinese herbal formulas, as well as give lifestyle/dietary advice. depending on the state we are in, we can be considered as primary care providers - which is a ton of responsibility.
i personally don't feel that this is enough clinical experience. especially because, in the united states (where i'm located and where i plan to practice), patients will be coming to us as a 'last resort', with complicated conditions and presentations and will have already seen many providers before. we do a few hundred hours of training in modern biomedicine, including anatomy, physiology, pathology, pharmacology, diagnosis. but it's basically a joke, compared to what rns, mds/dos, etc. do. we're expected to understand when we see certain serious conditions so that we can refer out.
i think the amount of training that acupuncture students do allows for a lot of mediocrity in the field. which has a lot of ramifications, of course. a way to get past this is to do a a 'residency' or internship with more senior practitioners. another problem is that a significant amount of people don't have very good business skills, and running a small business eludes them. it's hard to get employment statistics for this field - the few that i've come across say something like 50-70% of l.ac's stop practicing within 5 years of earning the license.
i do not want to become one of these people. i love doing clinical medicine, and i see the benefits in our modern medical system. the wisdom in the tradition i'm studying is also incredible, and i would love to combine the two, somehow. fyi, i used to work as an emt, so i have some experience in that field. i'm really interested in primary care, and want to work in underserved/rural areas. i would love to have a stable job. the stability of acupuncture is unknown, as it can take a while to build a successful practice (if you build one at all).
so, i'm considering enrolling in an entry-level np program when i'm done in about a year, and i'm curious what people here think of this idea - how feasible does it sound to open up a practice (in a state where nps can practice autonomously, for example), and do both traditional chinese and contemporary medicine? does it seem like these could complement each other? how possible would it be to see people in hospitals and refer them to my private practice, for example? i've looked at doing an md/do or pa - but i really dig the nursing model, and it seems like the aprn really fills a huge hole that is developing in healthcare. in addition to primary care, i'm also considering specialties in psych or occupational health, as these sound potentially synergistic as well.
it would be cool to have a dialog about this. i'm really keen on hearing what experienced people say.
