My review of TCM

[pilgrimsunwukun]

Plum and Cjr??

You guys are smart, reading you is like reading Sartre, which i don't understand. I try to keep the why and how of the medicine I use in the medicine's terms, leave research to the PHDs.

Back to the original topic, Chinese medicine can heal a lot. I had a tibial plateau fracture, tore my acl, and made mush of my medial maniscus. Went to the ER, had the blood drained was told I need reconstructive surgury. Started daily acupuncture, took lots of herbs. Went to a knee specialist who was recommended by a friend/teacher who said you need surgury and about $4,500 to pay for the operation( back in 1991) Never had the surgury, knee is better. Lots better.

Practitioners need to have skill that comes with time in order to treat severe health issues. Working with alopathic medicine is always good.

The point is I had many, many acupuncture treatments, ate about 100 pounds of herbs over a three month period. The specialist worked me into an MRI late at night to decrease the cost and after several months said ,"IYou don't need surgury." Never knew if my knee was truely better-probably was - or if the fact I lacked the $$$ prevented the surgury- played a part but not much probably.

CJ??? I quess New York lets PTs do tui na seize and grasp, whatever, out west its a finer line where chiro, massage, TCM is more clearly delineated. Anyway, how would a client, who needs to see you many, many times pay for treatment? Insurance doeasn't pay for multiple acu treatments, doubt it pays for multiple tui na/ massage/ whatever manipulations are called -maybe unless you're a chiro.

What I'm getting at is Chinese medicine worked on a severe structural problem but I was lucky, had access to excellent providers ( was in OCOM at the time) and the fees werer free or minimal. From September to December I had 50 acu treatments or so. Lots of herbs!!Chinese medicine that relies on insurance to pay for treatments prevents the long term care that is implied in the medicine. Ever read Bensky's book on acupuncture. A common phrase is something like," If the treatment doesn't work, review diagnosis and treat another 15 times."

Insurance based medicine makes it difficult for everyone to access the medicine. That's why some clinics decide on sliding scale so insurance does not dictate treatment. Visit Lincoln Memorial Hospital in the bronks to see acupuncture in a public health setting.

[cjurakpt]

Good post cjurakpt. The roots do go back a long time. However, AI, modern medicinal research, etc etc are infantile compared to the likes of fields such as Calculus, Physics, etc. It seems that much of the infancy of a field is shrouded in philosophy. As we make leaps forward, my guess is that things will become much more concrete in terms of the details and nuances of why this takles place--talking at the atomic level even, such as the calcium electrical gradients, etc... Were making great leaps however, and its an exciting time.

I guess the philospohy always comes first: maybe it's all Fritjof Kapra's fault?

One thing Id like to point out though is that a great deal of these types of things are actually linear in nature. A great great deal of the Universe can be adequately explained using linear time invariant methodolgies. For example, in terms of chaos models, many if not all of the models which are studied in a graduate setting are based on linear differential equations and their corresponding bifurcation diagrams are often times somewhat intuitive if you study the math of it and are familiar with the context of the setting.

I'm not familiar with the mathematical aspect of it, but sounds very interesting...

The problem with non-linear complex systems is that, naturally they operate and fail in complex ways; ways that can be very counter-intuitive. One of my graduate professors was at the frontier of working with non-linear time varying control systems. It was rather interesting to note that he was looking for PhD students to write dissertations so that he could continue trying to solve the big problems with our gaps in understanding here...A historical time in science right now...

always got to put those PhD students to good use, I guess - which is actually a relevant point for me, as I am currently looking around to decide what field I want to do my doctoral work in...

At any rate, while it is beyond the scope of this forum, if you are interested in seeing what starts as a simple example of how wacky non-linear time varying systems can be, Id be happy to go over with you an example from my graduate work. It would take a considerable investment in time, but it is an open invitation.

I'd be thrilled, for several reasons: first, personal interest in learning more about a field that intrigues me greatly but about which I know relatively little, so to have someone willing to spend some time walking me through it is a great opportunity; second, on a professional level: as a manually-based PT, I often see / do things that, if you tried to quantify them and analyze them from the typical cause / effect approach that medical research typically takes, this may not be adequate to describe it; at any rate, I am interested in doing research in this area, and my thinking was that the concepts of complexity, chaos, tensegrity etc. would be germaine to this sort of qualitative type of process; actually, my wife did her osteopathic doctorate work on the role of complex systems in regards to connective tissue in context of manual treatment, so there is certainly a precedent (except a lot of it's in French and Russian...); she'd be as interested as I am in what you are doing
I don't know what your proposal would entail, but I'm all ears...as far as the time investment, I don't mind doing it, just that for the next 6 to 8 months I'm still in a bit of a time crunch - after that, I will be on sabbatical for at least 3 to 6 months, so will have a lot of time to consider such things in more detail - if you think it's better to wait until that point, that's cool, otherwise, lay it on me...

At any rate, Id love to write more but need to get to work...But Id like to leave you with one of my favorite quotes, which I feel si pertinent: "If the human brain were so simple that we could understand it, we would be so simple that we couldnt."

great quote...

[cjurakpt]

Plum and Cjr??You guys are smart, reading you is like reading Sartre, which i don't understand. I try to keep the why and how of the medicine I use in the medicine's terms, leave research to the PHDs.

never could take Sartre all that much myself...

Back to the original topic, Chinese medicine can heal a lot. I had a tibial plateau fracture, tore my acl, and made mush of my medial maniscus. Went to the ER, had the blood drained was told I need reconstructive surgury. Started daily acupuncture, took lots of herbs. Went to a knee specialist who was recommended by a friend/teacher who said you need surgury and about $4,500 to pay for the operation( back in 1991) Never had the surgury, knee is better. Lots better.

nice...

Practitioners need to have skill that comes with time in order to treat severe health issues. Working with alopathic medicine is always good.The point is I had many, many acupuncture treatments, ate about 100 pounds of herbs over a three month period. The specialist worked me into an MRI late at night to decrease the cost and after several months said ,"IYou don't need surgury." Never knew if my knee was truely better-probably was - or if the fact I lacked the $$$ prevented the surgury- played a part but not much probably.

as long as it's better, on one level, who cares; on another, interesting questions you pose...

CJ??? I quess New York lets PTs do tui na seize and grasp, whatever, out west its a finer line where chiro, massage, TCM is more clearly delineated. Anyway, how would a client, who needs to see you many, many times pay for treatment? Insurance doeasn't pay for multiple acu treatments, doubt it pays for multiple tui na/ massage/ whatever manipulations are called -maybe unless you're a chiro.

in regards to tui na specifically, it's not something that would be differentiated from other tyes of massage, or mbilization: when you operate under a PT license, you can do any type of system you like, but you document / bill it as it falls under the CPT coding; so tui na would qualify as at least one of those areas; if you do an adjustment / manipulation, you code it like that - PT's are legally able to do that in NYS, but they don't care what "style" of manips you use: chiro, osteo, Chinese, orthopedic - it all falls under the same classification
as far as insurance, it depends on the individual carrier and what the policy says about PT - how many visits you get per year, per diagnosis, per person, reimbursement for out of network etc. are all things that vary considerably from one carrier to the next
many PTs have people just pay out of pocket and then submit to their insurance for reimbursement, as opposed to billing insurance themselves, which is a headache and very labor intensive;
as far as long-term treatments: I know a lot of PT places thrive on 3x a week for 6 months type stuff - my personal approch is to get you out as fast as possible: I know that there are people I've treated in 3 to 4 sessions with full relief of symptoms who would have been going to a typical PT place forever - but I do 1:1 for an hour, and use a lot of osteopathic manual therapy and qigong exercises, as opposed to just massage, hot packs, electrical stim and lifting weights...

What I'm getting at is Chinese medicine worked on a severe structural problem but I was lucky, had access to excellent providers ( was in OCOM at the time) and the fees werer free or minimal. From September to December I had 50 acu treatments or so. Lots of herbs!!Chinese medicine that relies on insurance to pay for treatments prevents the long term care that is implied in the medicine. Ever read Bensky's book on acupuncture. A common phrase is something like," If the treatment doesn't work, review diagnosis and treat another 15 times."

I ususally expect results in 1 to 3 treatments; if I can't get any change in 4 to 6 (depending) I refer them out to someone else (doesn't happen that much: bearing in mind that I also am good at screening who I think I can help to begin with, so if i don't think I can do anything for you, I refer out right away)

Insurance based medicine makes it difficult for everyone to access the medicine. That's why some clinics decide on sliding scale so insurance does not dictate treatment. Visit Lincoln Memorial Hospital in the bronks to see acupuncture in a public health setting.

I've heard Lincoln has a good program - although I think a lot of it is related to drug rehab, if I am not mistaken?

[pilgrimsunwukun]

As far as treatments, there are some people who can get by with 2 to 6 treatments but what do you with the chronic pain people? You know, the folks with bone on bone, severe osteo or RA, those who may be on 20 mg of methadone from a pain clinic and want to decrease the amount with their MD's blessing. The folks torn up from the floor up.

What about HIV, multiple sclerosis, asthma. Chinese medicine can really help lots of people, with the aid o f alopathic medcine or by itself.

I doubt 2 to 6 treatments and then their done would help. Some people need treatment for a life-time. That's because they choose the life-style of complementary medicine and try to treat patterns before they cause the structural changes that can be debilitating. Life-style also deals with diet, exercise, listenning to one's body, spiritual growth.

Sounds like kung fu can help.

Anyway that's it from me on this
Pilgrim Sunwukung

[cjurakpt]

As far as treatments, there are some people who can get by with 2 to 6 treatments but what do you with the chronic pain people? You know, the folks with bone on bone, severe osteo or RA, those who may be on 20 mg of methadone from a pain clinic and want to decrease the amount with their MD's blessing. The folks torn up from the floor up.

What about HIV, multiple sclerosis, asthma. Chinese medicine can really help lots of people, with the aid o f alopathic medcine or by itself.

I doubt 2 to 6 treatments and then their done would help. Some people need treatment for a life-time. That's because they choose the life-style of complementary medicine and try to treat patterns before they cause the structural changes that can be debilitating. Life-style also deals with diet, exercise, listenning to one's body, spiritual growth.

Sounds like kung fu can help.

Anyway that's it from me on this
Pilgrim Sunwukung

I would not treat anyone with a diagnosis outside of my scope of practice for their primary issue(s); if someone with HIV, MS, asthma came to me it wold be to help them adapt functionally to their diagnosis, not to "cure" it; certainly, these cases would take longer, but the philosophy is different: someone comes in with acute LBP, "frozen" shoulder, headache - if it's due to musculoskeletal issues primarilly, those are the "quick" treats; if it's myofascial pain syndrome / fibromyalgia, that's a different story - although I still try to keep the number of treatments to as few as possible, but for different reasons (mainly to prevent dependeancy - it's kinda complex: when you provide a chronic pain person with pain relief, especially too much too soon, they can either get dependent on you, or they try to "sabotage" your work - in either case, they try to get the process to be about you, not them - again, that's a generalized statement, but I've worked with a lot of these patients, they are a tricky group psychologically)
I've worked with a few patients on opiate pain killers - the really heavy stuff; these guys are tough: usually they've got so many meds in their system it's like a three ring circus that's never the same way twice; also, while they want to get off the meds, they are hooked, scared, etc.; I've had good temporary relief with the 3 or 4 I'm thinking about, but ultimately their dysfunctional lives, relationships, etc. were a stronger influence than the little windows they got after a treatment (and these were very labor intensive for me BTW), and they slipped back
on the bright side, i have had a fedw instances where people with years of pain got better after a very few sessions: usually it was something very specific that had not been treated out before ("subluxed" rib, strained hallux, misaligned pubic bone), and some people who I've treated for chronic stuff about 8 to 12 times, who then became steady patients about 2 to 3 times per year when something flared up, I'd see them 1 to 3 times and they'd be fine; over the years they woudl become much better at not only managing themselves (which laregely means learning not to hold their breath most of the day or noticing it when they do at least and breathing again!), but also predicting when they couldn't self-mange something that was bugging them and come see me right away so it wouldn't flair up - over time I'd see them less and less (and these were some folks who had been to "everyone" and gotten nowhere)"
BTW, with the chronic types of examples you cite: I almost always referred them to a colleague for simultaneous TCM treatment (I'm not stupid - I know it works... )

[PlumDragon]

I'd be thrilled, for several reasons.
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I don't know what your proposal would entail, but I'm all ears...as far as the time investment, I don't mind doing it, just that for the next 6 to 8 months I'm still in a bit of a time crunch - after that, I will be on sabbatical for at least 3 to 6 months, so will have a lot of time to consider such things in more detail - if you think it's better to wait until that point, that's cool, otherwise, lay it on me...

Great, this could be fun.

Essentially, we need to kind of measure your relevant skillsets to see how much (if any) background stuff we need to cover first. Once thats done, its really just a matter of solving a messy "homework problem". Depending on how much we need to cover in preparation, and depending if you want more, the time investment could be anywhere from just a few hours, up to and beyond several months.

Give me a day or so to dig up the material and get re-acquainted a bit; its likely Ill be doing som re-learning along the way. In the meantime, as to not derail this thread any further, Ill shoot you a PM and we can go from there...

[DDG]

I realize I am late to this discussion and new to the site but I wanted to add a couple of things

If a person is a graduate of a TCM school in China they are trained in mainly TCM but they are also trained in Western Medicine.

If you go to a large hospital in China you have both TCM and Western medicine working together to treat a patient and there are certain things that TCM treats incredibly well such as chronic conditions and there are things that Western Medicine treat very well and the doctors there refer patients between the 2 depending on the condition.

Also not knowing where everyone is from in this thread I will add that in China TCM doctors send their patients for x-rays and other medical testing and they are able to do treatments there that are not allowed in the US since they are not MDs. In China they do give herbal injections the same as a western doctor gives vaccines but it is not legal for an OMD to do so in the US.

In the US you do not get the full treatment that a TCM OMD is trained to do, they are not allowed by law. Also many of the TCM schools in the US do not train their students as much or as well. Many programs in the US are masters degree 2 year programs where a OMD in China goes to school for greater than 4 years and the US department of labor rates that education as 6 years of training based on the credits required in China to get the degree.

And finally

When TCM came to the West many doctors said it was useless. The funny thing about that is when Western medicine got to China many TCM docs there said the same thing, it was useless. But in China they now work together rather well. I can only hoe that the US figures this out and catches up

[pilgrimsunwukun]

I've said it's good to have access to x-rays, MRI's, blood work, pfts, and all sorts of other western diagnostic tools. In the US they help acupuncturists but the reality is that 95% of clients who come to an acupuncturist have already had their broken bone set. Cystic fibrosis patients are working with a pulmonary or other type of doc. Hep C people know they have HeP C and are waiting to get on interferon after their biopsy or are making the decision to use herbs, lifestyle changes to slow down the progression of fibrosis(hopefully). People with Raynauds have all the blood work they need, ie, they have the diagnosis already and are deciding to get complementary and alternative medical care. People with axis I or axis II issues are already diagnosed. So the western info is often already available.

Sorry but there has never been a two year master degree acupuncture school. Maybe in the early days people become diplomates of acupuncture after two years but that was long ago. Like 20 years. All schools with masters programs are three years and if you do it in three you work your ass off. Most are now four years which is a long time to get a masters degree, even three years is long. Compare that to a masters in english, history, chemistry.

The amount of time learning western medicne A and P, western clinical diagnosis, pharmacology, strunctural diagnosis, on top of the Chinese stuff is lots of work. And it gets more intense year after year. Remember most school want people to be able to pass California's acupuncture exam and that test gives people the chance to be primary care providers. (Thank God not all states have acupuncturists s primary care providers.)

I've heard the Chinese doc thing- being a MD and a doctor of Chinese medicine. Funny thing is those same Chinese doc can't practice in the US unless they are able to pass their particular states board. Often they don't pass right away, mostly due to language issues.

The other part of being a Chinese doc/ acupuncturist in China is I hear newbies get the easy cases. I mean you're just out of school and .....So the more experienced get the hard cases.

In the US I guess their's a move for TCM people to work in hospitals ( especially if you have a PhD/ Doctorate degree) but most work in private practice. They take on hard cases and can be very successful.
Pilgrim

[dougadam]

Where TCM goes wrong: No use of modern equipment. A training partner of mine had some horrible pain in his wrist. He went to the TCM doctor and received accupuncture. It did temporarily relieve the pain. When the chronic pain continued he went to a hospital and it turned out his wrist was broken.

How could you not know your wrist is broken?

[DDG]

I've said it's good to have access to x-rays, MRI's, blood work, pfts, and all sorts of other western diagnostic tools. In the US they help acupuncturists but the reality is that 95% of clients who come to an acupuncturist have already had their broken bone set. Cystic fibrosis patients are working with a pulmonary or other type of doc. Hep C people know they have HeP C and are waiting to get on interferon after their biopsy or are making the decision to use herbs, lifestyle changes to slow down the progression of fibrosis(hopefully). People with Raynauds have all the blood work they need, ie, they have the diagnosis already and are deciding to get complementary and alternative medical care. People with axis I or axis II issues are already diagnosed. So the western info is often already available.

95% of the people in the US, not China and I am referring to China. People get diagnosed by TCM docs in China as well as western docs and the TCM diagnosis is not done in the same way that it is done in Western Medicine. However as stated a TCM doc can send a patient for tests.

Sorry but there has never been a two year master degree acupuncture school. Maybe in the early days people become diplomates of acupuncture after two years but that was long ago. Like 20 years. All schools with masters programs are three years and if you do it in three you work your ass off. Most are now four years which is a long time to get a masters degree, even three years is long. Compare that to a masters in english, history, chemistry.

Sorry but I probably should have said masters program and not put a time on it and I am not saying they do not work hard, they do work very hard. But they are not given the same amount of training that one gets in China. 1 year, 2 years, years 3 or 4 years is still less than the 4 they are given in China that is equivalent to a 6 year credit load in the US.

The amount of time learning western medicne A and P, western clinical diagnosis, pharmacology, strunctural diagnosis, on top of the Chinese stuff is lots of work. And it gets more intense year after year. Remember most school want people to be able to pass California's acupuncture exam and that test gives people the chance to be primary care providers. (Thank God not all states have acupuncturists s primary care providers.)

Yes it is and they work hard to get it, I am not saying that they do not and as to the most schools wanting to pass the California exam, I would not know, never hear that one but I am on the opposite coast and they are more interested in passing the NCCAOM exams.

I've heard the Chinese doc thing- being a MD and a doctor of Chinese medicine. Funny thing is those same Chinese doc can't practice in the US unless they are able to pass their particular states board. Often they don't pass right away, mostly due to language issues.

And your point is? Are you saying you consider them inferior there for the fact they work well with TCM is not surprising. If so you are way off.


I will admit a surgeon in the US is generally better than one in China but most doctors in China are very good. I know one personally that is in the US and he is not working as an MD he is a chemist. I also have a family member that is an MD in The US that is helping an MD from China become an MD here and he is very impressed with the knowledge that this person has.


Understand a typical school year in China requires a lot more credits than we are required to take in the US. As I said 4 year equals 6.

The other part of being a Chinese doc/ acupuncturist in China is I hear newbies get the easy cases. I mean you're just out of school and .....So the more experienced get the hard cases.

This is just plain wrong. In China ALL docs whether an OMD or an MD has to go through an internship and at this time you are correct they follow a more experienced doc. But once they graduate they are treated much the same as a new doc in the US, they get the jobs other docs do not want. I personally know someone that graduated form a TCM school in China and was put in the ER on 3rd shift of a rather prestigious hospital> And I don't know about you but dealing with an ER and having your first major case on your own after graduation being a motorcycle accident does not sound like an easy case to me

In the US I guess their's a move for TCM people to work in hospitals ( especially if you have a PhD/ Doctorate degree) but most work in private practice. They take on hard cases and can be very successful.
Pilgrim

They are in China why would it be different here?


I am not saying that those trained in the US are not good or not talented I am saying that they do not get the training like they should and that is no fault of their own it is the system in which they live and work.


I am done here by the way because I highly doubt any further comment by me will change anyone’s mind and it sounds as if you have already made your decision.


I should also add one final thing. I am only speaking for the North of China, I have little knowledge of how training and hospitals are run in the South.


My best to you
DDG

[bodhitree]

How could you not know your wrist is broken?

Quite easily.