Jack Miller, LAc, has been the president of Pacific College of Oriental Medicine since 1988. In his 15 years as president, he has helped make Pacific one of the nation's leading educational institutions, engineered the school through two expansions (with branch campuses in New York and Illinois), and established positive relationships with lawmakers and other health care professionals.
Recently, Acupuncture Today interviewed Mr. Miller and asked about his position within the college; the role Pacific plays in the acupuncture community, and the important issues (educational and political) concerning the profession. Part one of this interview appeared in the July issue.
Acupuncture Today (AT): Considering the fact that Pacific is offering a doctoral program now, and several colleges have doctoral programs or are preparing to offer them, what do you think is going to happen to the master's degree in the profession?
Jack Miller (JM): The honest answer is, I don't know. We face pressure particularly in California, from some politicians within and outside our profession, to make the doctorate an entry-level program so people would not be allowed to practice if they only graduate from a master's level program. I don't favor that. I think at this point, we've got a really beautiful situation in the profession where people can do their master's degree, then go into practice. They can practice safely - we've proven that for the last 20 or more years - and then they can obtain their post-licensure doctorate while they're working in the field that they've chosen.
I think that allowing the doctorate to remain optional for some time will allow us to see the real value of doctoral-level training. If at some point, everybody in the field sees that having the doctorate provides them a competitive advantage in the marketplace, it allows them to give better care to their patients, and their patients are more likely to see them because they have the doctorate, the doctorate will become the de facto standard in the field. We won't even need to have legislated it; people will just do it because they'll need it to be competitive.
If, though, after some years, not many people are doing the doctoral training, and patients aren't seeing any difference that they're willing to pay for between people who have doctorate-level training and people who have master's-level training, then we might see it become just a degree for faculty, or advanced researchers, or specialists, in which case we wouldn't want to have legislated something like this. So we're really kind of blessed with the perfect situation of being able to see the true value of this, rather than having to legislate it hastily. I hope that's what happens. I really don't understand the frantic push for the doctorate as entry-level, particularly since it's being pushed by people who don't want to or are unwilling to do that level of training themselves.
AT: What has been the response from the profession so far? Is there a lot of interest in the doctoral program?
JM: Yes. There's a lot of interest. In round numbers, though, let's say there are 10,000 acupuncturists in this country. I certainly haven't seen 10,000 people say they're interested in doing the doctorate. Some of the most successful practitioners I know, people who have had the biggest impact on increasing the visibility and credibility of our profession, that have done the most in terms of authorship, research, and things of that sort, don't even have the master's degree. The degree you have is only part of the equation as to how successful you'll be.
There's a lot more, and there's really no limit to what you could do. You don't have to depend on having a (doctorate) degree. It's great that we have it as an option in our field. I think it's wonderful. I've been the chairperson for the doctoral committee for the Council of Colleges of Acupuncture and Oriental Medicine since its inception, and so we've certainly - both Pacific College and the Council of Colleges - worked hard to have more advanced training in the field, but at this point, we'd still really like to see it be optional rather than to force people into taking it.
Right now, we're shooting for a September start. We've just started to promote it. We'll see just how much interest there is in what we've created, and in the doctorate in general.
AT: PCOM's going to have its symposium a couple of months after the doctoral program starts. How are things proceeding along those lines?
JM: The symposium's always a great event. We have a lot of fun doing it. It's really a labor of love. We get to see people who have been at every symposium. This is our 15th anniversary, so not only are those people attendees, they're friends of the college. It's great to see the people who show up, and the speakers are always great. We look for the best in the field. This year, Giovanni Maciocia will be back; Alex Tiberi; Lonny Jarrett; Paul Unschuld, who's probably one of the foremost scholars in our field, will be here again. He's got a new book, a new translation of the Nei Jing, a substantial and well-researched translation, which is really essential for our field. Jeffrey Yuen is always a treat to have there.
AT: Whose idea was it to have a symposium each year?
JM: I guess I have to take blame for that! (laughs) But I'd really like to give credit to Joe Lazzaro, who was one of the founding shareholders of Pacific College. He passed away a couple of years ago, and we really miss him. It was Joe's inspiration. He had established a retreat with Ted Kaptchuk that was scheduled just about the time I started at Pacific College, and so I suggested that we get a few other speakers involved and do something on a little grander scale. That became the Pacific symposium. The first one was at the Kona Kai in 1989. Joe was certainly a big inspiration for that.
AT: What differences do you see between meetings held by colleges such as PCOM, and meetings held by a state or national association?
JM: I think there's a certain commonality in attendees and speakers, but I think the biggest difference, at least at the Pacific symposium, we consciously limit the political aspect of the symposium. Barring a life-or-death emergency in our field politically, we really want the Pacific symposium to be a retreat from those kinds of issues. We can certainly go one weekend without arguing about whether the doctorate should be entry-level, or whatever we happen to be dealing with at the moment. I have tried to use the symposium in the past to put people from various sides of issues together. I remember putting Michael Smith together with some of the people in California about acupuncture detox technicians and those types of issues, but in terms of having the microphone of podium used to advance political issues, I'd like to leave that to our political associations. I really look at the symposium as an academic and retreat environment.
AT: I have a few more questions, if that's all right.
JM: Sure.
AT: Acupuncture Today conducted a poll about the most important issues facing the profession this year, and "improved educational standards" came out on top. Do you think educational standards should be our biggest priority, or are there other issues we should be concerned about?
JM: I think education and research should always be high on the list of issues for any profession. I don't think any profession should become static, and I think we should always look at how to train our students more effectively and efficiently, to give them more quality for the time and money they put into their education. That doesn't always have to mean more hours, but sometimes it does. Pacific has always been known for having a very comprehensive training program. We're at over 3,300 hours now, but I don't know when people say "improved education standards," if they mean more hours, or just improving. Sometimes, you could do more with less if you work smart.
Improved educational standards is certainly the number-one issue at Pacific College. It should certainly be the number-one issue at our colleges. We should always strive to improve our educational standards. We just spent close to four years revising seven core courses in our program to create a truly integrative medicine curriculum. Whereas we've been doing the differentiation and treatment of disease from a Chinese perspective, we are now integrating how to use Western medicine, so that students can see their teachers modeling how to really use Western medicine.
We've always been known for having a strong biomedical department, but having a lot of hours doesn't always give the students a great idea of how to use it. So when the students are getting the differentiation and treatment of disease, they're also getting instruction on which lab tests to order; radiology; the community resources for particular specialties, and how to interact with your Western colleagues. These are the kind of things all schools are doing now - not necessarily with that specific kind of curriculum, but they're always thinking about how to train their students better.
AT: Speaking of schools, you've probably noticed that several acupuncture schools have closed in the past year. How much does that concern you?
JM: It's certainly something we have to pay attention to. We have to look and see: What was the cause of those schools' failures? Are there any things they did that we're doing, or are these just isolated incidents, and is it a coincidence that we've had a few in the last couple of years? To me, it does look coincidental. I don't think there's a diminishing interest in our field; that's clearly not the case. But I think it may be that the smaller schools just have a lot harder time surviving, since the more established schools have been doing this for 15 or 20 years. It's going to be hard for a smaller school to make it. The barriers to entry are just a lot higher than they were 15 to 20 years ago. Back then, you could grow organically. You could start in a one-room schoolhouse, with one administrator and one teacher doing everything, but I know from my experiences starting both the New York and Chicago campuses that you can't really do it like that anymore. You have to start as if you have 200 students, even if you only have one. You've got to absorb losses for quite some time. So I don't see how the smaller schools are going to be able to do it.
AT: Are there any emerging trends or issues you see happening? Anything else we need to be concerned about?
JM: In terms of emerging trends, I think the mainstreaming of Oriental medicine is certainly going to continue. Acupuncturists have to be ready for that. In that way, I agree with some of the people that are pushing the doctorate as entry-level, in that acupuncturists need to be able to interface with their medical colleagues. I'm not sure we need to be able to do everything that they do - division of labor has made the modern world what it is. I think we can be specialists within the health care community, but we definitely need to feel comfortable working at a variety of settings. I think the profession needs to continue to do research. Maybe at this point, we don't need to be so concerned about validating our principles, although that's certainly important work. Maybe we can be a little bit less concerned about proving that acupuncture works. I think we can start to say, "Well, we know acupuncture works for something. How do we make acupuncture work better for that?" Let's do some research on how to improve the quality of care we give.
In terms of concerns, I continue to be concerned about some of the division in the profession, the need that some people feel to legislate that everybody looks the same in the profession. I think we've really been blessed by the ability to be a diverse profession, and for our students to go out into the workforce and create practices that are a reflection of their interests and their personal styles, and the patients they want to treat. Surely we have to have minimum standards of safety, but I don't know that we all have to be or look the same. I think that if we can maintain that diversity, we're going to be able to continue this grassroots expansion that we've had into the community.
Our patients don't care if they call us "Doctor," "Master" or "Mister." They just want good health care at a reasonable price. They want effective health care, and I think we've been doing that for some time, and we're going to continue to get better. Standards are increasing in all areas because, if you're not getting better, you're going backwards. The schools want to get better, because they want to stay in business. Acupuncturists want to get better, because they want to do better for their patients and be able to get more patients. I don't think we have to worry so much about legislation. I think that really detracts from what we can do together as a profession. I see acupuncturists, professional associations, lobbyists, school administrators and other politicians spending a lot of time working against each other, when if we could just pull together ... the public is clamoring for what we have to offer. We should turn our direction toward them, and tell them how good we are. Sometimes it seems like we're our own worst critics. Maybe that's healthy. Maybe there's a certain trial by fire that we go through, but it seems like we could be more proactive in our outreach to our patients.
AT: Thank you, Dr. Miller.
JM: Thank you. And please, don't call me "Doctor" (laughs).
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