Dr. Tia Trivisonno is a naturopathic physician and licensed acupuncturist who has been in practice for 15 years in Long Island, NY, a state where ND licensing still hasn't passed. She surfs and rides a cherry red Harley Sportster, both beautiful tools in what she calls the "Treasure Chest."

Tia has figured out how to use that Treasure Chest and self-discovery to keep the lights on. This isn't through bypassing the hard stuff, but by using this as a collection of things to bring oneself back to center when the grief, the debt, and the weight of a profession under pressure start to feel really heavy.

If you've been feeling the weight of this moment in our profession, Tia is exactly the kind of company you need. She's a solutionary out there riding the waves and the roads and she's bringing all of us along for the ride.

Zachary Krebs came to acupuncture through love, a decade of Tai Chi, and a brain cyst that went undiagnosed by pretty much everyone he saw until he typed his symptoms into ChatGPT and got an answer in seconds.

In this episode: what martial arts teaches you about the body that acupuncture school doesn't, what happened when he sat in a CEU class in severe neurological pain while practitioners took his pulse and nobody wrote down the word pain, and why he thinks pretty much all acupuncture is decent and you should be skeptical of exceptional claims.

Zachary is the co-founder of Fire Rabbit Acupuncture in Oregon City, Oregon. He trained at POCA Tech, now the Oregon College of Community Acupuncture, and graduated in 2022 with no debt.

On April 11, 2026, the Oregon Association of Acupuncturists and Education Task Force held our first community town hall on the proposed Oregon administrative rule revision that would create a state-regulated, competency-based alternative pathway to acupuncture licensure.

If you couldn’t make it, here’s what we covered:

* Why the RISE Rule and AHEAD Framework put virtually every ACAHM-accredited program at risk of closure by 2028

* What a parallel, OMB-approved licensure pathway would actually look like and what it wouldn’t change (scope of practice, clinical hours, exam)

* Where we are with NCBAHM on exam eligibility for state-pathway graduates

* What we need from Oregon acupuncturists between now and our May 1st AAC submission deadline

The full proposal goes to the Acupuncture Advisory Committee on June 5th. We want to hear from you before then, especially if you're an employer or know someone who is.

This is available as a Videocast on Substack with captions. Some interviews you schedule around convenience. This one we scheduled around continents.Sushila Gurung lives and works above the clinic she runs in Bajrabarahi, Nepal, which means that when we finally found a time that worked for both of us, it was late at night for me in Portland and early in the morning for her, with a wifi connection that did its best and occasionally reminded us just how far apart we actually were. Sushila joined the Acupuncture Relief Project as a medical interpreter when she was 18 years old and she now works as the Clinical Director for Good Health Nepal, where acupuncturists work as primary care providers in a rural region with a catchment area of 150,000 people. In this conversation we talk about what it means to become a practitioner in a country where acupuncture isn't yet fully regulated, the education pathway that exists and the one that doesn't yet, what the COVID reopening really looked like from the inside, and what she wants practitioners everywhere to understand about this medicine and what it can do.You can find out more about the Acupuncture Relief Project. https://acupuncturereliefproject.org.And you can make a donation to support Sushila, Satyamohan and their team at: https://acupuncturereliefproject.org/donate

Felicía Desrosiers found acupuncture in Quito, Ecuador in the year 2000. She went on to attend POCA Tech in Portland, teach there, and found North Portland Community Acupuncture, a pop-up clinic in a bar that she made feel sacred every single day she opened it. She is now in Madrid, Spain, doing it all over again.

In this episode: why she thinks acupuncture is an adaptogen for the medicine and for the people who practice it, what it actually takes to make a space feel holy, why a practitioner who knows ten points and shows up with intention can change someone's life.

Also: a temescal in Mexico, a Scrabble word on a train, and why she thinks we should have acupuncture clinics everywhere the same way we have restaurants.

Danielle Reghi graduated from OCOM with $220,000 in student loan debt: a number she didn't borrow, but accumulated through compounding interest nobody explained to her. In 2021 she filed a Borrower's Defense application. Four and a half years later, she received full discharge of every loan under her name.

In this episode, Danielle, owner of Zen Space Acupuncture in Portland and current president of the Oregon Association of Acupuncturists, talks about building a multi-location practice from $24,000 a year, what a realistic living wage looks like for an acupuncturist, and why she thinks the cost of acupuncture education is the single biggest threat to the profession's future.

Matthew Bauer has been practicing acupuncture in Southern California since 1986. In this episode: why acupuncture research keeps underestimating the medicine, and what a debt-ridden new grad can actually do with that information, the four cornerstones of this profession and how they failed each other, and what it means when a patient says I wish I'd have known.

Also: Making Acupuncture Pay. A good read.

Bex sits down with Debbie Yu, Doctor of Acupuncture and Chinese Herbal Medicine, owner of Little Si clinic in North Bend, WA, former Bastyr faculty, and creator of the Doggy Oracle Card deck. They met in Nepal in 2015 doing rural primary care through the Acupuncture Relief Project — and a lot of what shaped both of them about this medicine happened there.

In this episode: the real numbers behind Debbie's student debt ($70k for a doctorate she'd skip if she could do it over), why raising cash rates isn't as simple as it sounds when most of your patients are on insurance, the crossroads the profession is actually at, and what it felt like to finally, after twelve years, make a livable income.

Also: dogs as medicine. Seriously.

Honest, funny, and a little bittersweet. This one's for anyone who loves this medicine and is still figuring out how to make it work.

Kelly Ilseman has spent four years as the unpaid Research Committee Chair for the Oregon Acupuncture Association, doing the behind-the-scenes work that keeps our profession moving. We talk about what it takes to get insurance coverage, how to translate between East Asian medicine and biomedical language, and what integration into hospitals and the VA actually requires of us. Plus: the OAA is looking for someone to take over Kelly's role. Could that be you?

Terry owns Eagle Cap Wellness in Enterprise, Oregon, a small town in the Wallowa Mountains near the Idaho border. She graduated from OCOM in 2013, went straight to Nepal with the Acupuncture Relief Project, got certified in Sports Medicine Acupuncture, and then in 2022 made what she calls an impulsive but necessary leap: moving from inner southeast Portland to a town where her old neighborhood probably had more people than the entire county. She bought the supplies from the departing acupuncturist, stepped into the space, and started seeing patients within weeks.

What she didn’t anticipate was how much she didn’t know: that running a small business while carrying graduate school debt would make her nearly invisible to mortgage lenders. That she and her husband would end up living in a 24-foot travel trailer behind the clinic for eighteen months. That getting called for jury duty on a Thursday,her busiest day, would genuinely stress her out because there is no buffer, no FMLA, no unemployment. Just the constant low hum of what if.

And yet her practice is full. Her patients refer their neighbors. The physical therapist at the local hospital sends people her way. She is, by most measures, exactly what a rural community needs and can’t easily find.

This conversation covers what rural practice actually looks like on the ground: the seasonal rhythms of ranch life, the collaboration with PTs, the mortgage application that didn’t go through, and the gratitude list she and her husband keep on the wall of the clinic for the hard days. Also the deer that graze behind the building and the quail that live in the bush down the hill, because sometimes that’s what keeps you going.

Terry is clear-eyed about the fragility of all of it. She’s also clear that she loves this medicine, and that when a patient comes back saying they felt amazing, it still makes her squeal.