What does meaningful accountability in acupuncture education look like and why does it matter now? Join Bex Groebner, Danielle Reghi and Ryan Hofer for a detailed conversation about accreditation, student debt, career outcomes, and the future of acupuncture education. We unpack the role of ACAHM and NACIQI, the gap between program costs and real-world earning potential, and why professional organizations, students, and practitioners all have a role to play in shaping stronger standards. The conversation also offers practical guidance for anyone who wants to participate in the upcoming NACIQI hearing through written or oral testimony.

Major details:

* Review happens September 24th

* You must register by September 16th to be able to watch/listen 🍿

* To make an oral or written comment, you must email [email protected] by September 16

To make a comment:

* Submit an email to the [email protected] mailbox.

* In the subject line, write: “Oral Comment Request: [NACIQI review Accreditation Commission for Acupuncture and Herbal Medicine]” or “Written Statement: [NACIQI review Accreditation Commission for Acupuncture and Herbal Medicine]”

* The email must include your name(s), title, organization/affiliation, mailing address, email address, and telephone number.

In this episode

* How practitioners and former students can make effective written and oral comments

* What accreditation is meant to do for students, schools, and the profession

* Why rigorous standards should include real career readiness, not only academic requirements

* The student-debt crisis in acupuncture education

* How tuition, loan structures, and earnings data can create misleading expectations

* Why self-employment and limited hospital employment matter when evaluating outcomes

* The importance of financial stability, transparency, and independent oversight

* How practitioners and former students can make effective written and oral comments

About the guests

Danielle Reghi

is president of the Oregon Association of Acupuncturists and owner of Zen Space Wellness in Portland. She is an acupuncture practitioner, policy advocate, and co-lead of the OAA Education Task Force. She writes about the acupuncture profession at Holistically Driven.

Ryan Hofer

is executive director of the Pain Relief and Education Collective and a specialist in pain management. He has represented student borrowers in federal negotiated rulemaking and writes about debt and healthcare education at Debt by Natural Causes.

Resources mentioned

* NACIQI hearing registration and oral-comment information

* Written-comment guidance

* 34 CFR 602 accreditation standards

* ACAHM 2014 letter against accountability metrics

* ACAHM 2026 opposition to AHEAD accountability metrics

* DOE approval for ACAHM accreditation

* NCBAHM Test Score pass rates

* Sorted HEA group data

* Bureau of Labor and Statistics data acupuncturists

* Qiological Wayfinding the Future Series with Danielle and Ryan episodes

Listener takeaway

If you have personal experience with acupuncture education, student debt, school closures, or career outcomes, consider sharing a concise, specific, fact-supported written comment and registering to speak at the hearing.

Michael McMahon has been a licensed massage therapist and acupuncturist in Portland for 25 years, and is the founder of Moving Mountain Institute. He’s one of the most thoughtful educators I’ve ever encountered and one of my oldest friends and mentors in this work.

Michael came to bodywork and acupuncture through a convergence of many things, including a cancer diagnosis in massage school, a lifelong love of classical Chinese poetry, and many years of leading wilderness programs for teenagers. His approach to teaching is rooted in Paulo Freire, bell hooks, Linda Barry, Fred Moten and Stefano Harney’s The Undercommons, and the simple, radical idea that if you spend 80% of acupuncture school sitting in a chair, you’ve taught people how to sit in a chair.

In this conversation we talk about what it actually means to teach this medicine, flipped learning, backwards design, why safety and fun belong in every anatomy syllabus, and why the institutional status quo is often standing in the way of best educational practices. We also get into the financial realities of running a small business as a bodyworker, including debt, retirement, SEP IRAs, raising your rates every year, and what it means to be scared about your future in a profession that never teaches you to plan for it.

This one is for practitioners, educators, students, and anyone who has ever sat in a chair for four years and wondered if there was a better way.

Resources mentioned in this episode:

Michael’s Work

* Moving Mountain Institute

* Sign up for Field Notes — Michael’s newsletter, worth every email!

* Community Events and Anatomy Talks

* Gil Hedley — the best anatomy resource for bodyworkers and acupuncturists

Financial Tools

* The Thriving Acupuncturist Calculator — the spreadsheet Bex and Michael built together

Books We Referenced

* Cold Mountain Poems — Han-shan, translated by by Gary Snyder

* Pedagogy of the Oppressed — Paulo Freire

* Teaching to Transgress — bell hooks (Michael says start here before Freire)

* Syllabus: Notes from an Accidental Professor — Lynda Barry

* The Undercommons — Fred Moten and Stefano Harney

Workforce and Policy

* Acupuncture Workforce Alliance

My guest today is Jen Maiorana, a second-year acupuncture student who’s already transferred through three different Chinese medicine schools trying to find solid ground. She’s got a background in environmental studies, business, and running her own wellness practice, and she spent the last few months trying to figure out something most students don’t even know is an option. So we’re gonna talk about that along with funding and mentorship. It’s a big compost pile out there, but flowers grow out of compost.

Below, you’ll find some important links from our conversation today. You can watch the video at: https://www.youtube.com/watch?v=U3Y4BhJMD38

Find Jen Maiorana at her Linked In page here.

You can find information on California’s Tutorial Program here. If you’re weighing whether to keep paying acupuncture school tuition right now, you might want to check out the program Jen talks about. It runs through the California Acupuncture Board. Instead of enrolling in a school, you apprentice one-on-one with a licensed supervising acupuncturist who’s held their license in California for at least five years and has at least ten years of practice experience. The state requires a structured curriculum (2,250 hours of supervised clinical training plus 1,548 hours of theoretical and didactic coursework) that comes to 3,798 hours total, completed over a minimum of four years, with a cap on how many hours can count per 12-month period so the program can’t be rushed. Application runs through the Acupuncture Board for a $1,000 fee, and once you’re approved and complete the hours, you sit for the same California state licensing exam as anyone graduating from an approved school.

California law prohibits any tuition being paid to the tutor. That protects students from being charged twice, but it also means you’re responsible for finding your own supervisor and negotiating what you’ll offer in exchange for the training. Jen talks about admin support, scheduling, marketing, and even carpentry skills. It really has to do with your personal talents, since there’s no statewide matching service. Pine Street Foundation in the Bay Area is one of the longest-running tutorial programs in the state (supporting tutorials since the early 1980s). It’s not a shortcut, and it’s not for everyone, but if school tuition is what’s standing between you and this profession, it’s worth knowing this door exists.

Other things we talked about in this conversation include:

* Pine Street Foundation’s information page on the California Acupuncture Tutorial Program.

* NCBAHM Certification Handbook that includes information on NCBAHM Route 4 pathway and the Frequently Asked Questions fact sheet about why NCBAHM eliminated the Route 3 apprenticeship pathway.

* Michael McMahon and Moving Mountain Institute.

* Gil Hedley’s site where you can sign up for a membership to watch anatomical cadaver videos and earn continuing education credits.

* Here is the website for Acupuncture Relief Project in Nepal that has a news blog and more information as well as the program application.

Thanks so much for listening!

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.