My review of TCM

[bodhitree]

My wife has been working for a chinese medicine doctor (who I've known for a while) and we don't have health insurance, so as a cost effective alternative we have been using chinese medicine.

I think for minor problems TCM can be very effective. I have suffered from (and my father always has also) sinus problems for a long time. We bought pills the doctor recommended and it has helped me to sleep at night. My wife has also bought some medicine for her teenage brother's acne, which has worked rather well.

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.

TCM is great as a supplement to western medicine and has a lot of things to improve one's lifestyle. Modern medicine has the best diagnostic technology. It's not about one vs. the other. It's about balancing both and knowing when one is needed and when the other could be more beneficial.

[herb ox]

One thing I've noticed personally is that TCM programs in the past few years have really placed an emphasis on proper use of diagnostic tools (that's not to say the practicioners will actually use them). We're trained to look for 'red flags' that require referral to western practicioners or at least to use modern diagnostic methods. TCM practicioners need to not be lazy and send a patient to the lab or for xrays to better determine what's really going on - especially if the client has medical insurance, if not, it is a bit more complicated. TCM students of old (in America) often don't have that same emphasis or experience in western medicine and diagnosis. At my school, 1/4 of the classes are based on western medicine. It's funny because I've heard from many older (non-Chinese from China) practicioners that students now are receiving a much better education then they did and as a result we'll be better practicioners :o

In any case, these sort of things do happen - in both Western and Eastern practice. Misdiagnosis on both sides is a lot more common than one would think - even with radiology and lab work.

Your experience is valuable as it reminds me to take every complaint seriously, and give it my full attention. A simple complaint of wrist pain would likely incur a simple treatment without much examination. Some practicioners wouldn't even give much of an interview before placing needles. A thorough interview along with orthopedic examination would likely suggest something more than just a sprain or 'qi blockage'.

However, I must respectfully disagree with your blanket statement of TCM only being good for minor problems - a good praciticoner should be able to spot the major problems and take the appropriate route of action, be it use of modern diagnostic tools or referring out to an allopathic physician. However, I do agree with your closing statement about knowing when to apply one or the other - although western diagnostic tools are quite good, they don't always catch the true problem...

thanks for sharing your experience, bodhitree.

peace

herb ox

[bodhitree]

Keep us posted on your progress too, its interesting to hear about trining involving western medicine. The Doctor my wife works for is a middle aged woman who was trained in Hong Kong. I don't know what that means. I think TCM should be used to supplement western medicine, and I know she has things to fight the fatigue of chemotherapy and so forth, two approaches combined = one way to complete health.

[cjurakpt]

Interesting about the wrist: tells you a few things

1) taking a history is vital: in other words, there must have been some precipitating event that caused the wrist pain - a good hx. would have possibly "red flagged" the relative liklyhood of a wrist fx. and indicated the need for radiographs; I don't know if maybe it was that the hx. was taken from a TCM perspective, but even so, I can't imagine that wouldn't have involved asking if there had been a recent taumatic event...of course, a rip to the orhtopod would have resulted in films being taken pro forma, so even if the hx. was lousy, the films might have shown a fx. (although the latest stat. I heard was that something like 30% of cerical fx. go unnoticed on x-ray...scary)

2) despite the fx., TCM helped, meaning that the acup. was able to help mediate the local inflammatory process and decrease the pain appreciably; consequently, there has been some study on the effects of TCM on fx. management, such as casting in a removeable splint apparatus so that periodic acup. and gentle ROM could be administered while the fx. was healing - if i recall correctly, the sample group did markedly better than the controls

what this indicates overall is that the principles of allopathic and TCM are not mutually exclusive: so e.g., you x-ray the wrist to get the right dx., the you provide some acup. to dec. pain / swelling right before casting, and you can use a bivalve casting technique to allow administration of acup. during healing; of course, I'd like to see some well designed, double blind RCT's to back it all up at some point as well...

BTW, let's see how long we can string this thread out and keep it civilized...

that said, I'd be very interested in anyone's perspective on what is really "going on" in terms of why TCM "works"; I certainly have my own perspective, which is that there is nothing that TCM can accomplish that can't be adequately described with the already extant western anat/physiol knowledge that is available, it's just a matter of understanding how the organism functions in an at times non-linear, complex systems based context...

[cjurakpt]

One thing I've noticed personally is that TCM programs in the past few years have really placed an emphasis on proper use of diagnostic tools (that's not to say the practicioners will actually use them). We're trained to look for 'red flags' that require referral to western practicioners or at least to use modern diagnostic methods.

that's it in a nutshell! the drawback of tradidional medicines is that they had limited diagnostic capabilities - so if you train TCM practitioners to "step outside" their paradigm and use contemporary knowledge to ID those "red flags", then you are using best of both worlds; BTW, the reason for the emphasis is that, if you are functioning as a licensed healthcare provider, if you don't deliver an appropriate standard of care, you gonna get yo' a$$ sued and livelyhood dumpd in the toilet; so no surprise schools are focusing on this sort of thing - safety first!

[pilgrimsunwukun]

There's still cancer in the US and flu in China meaning no medicine holds the key or is the right way of healing. Every method has it's strengths and often it is the practitioner that has the weaknesses.

There was a Chinese doc in NYC named John Shen who said something like," Chinese medicine is easy to learn but hard to do , western medicine is hard to learn but easy to do."As a doc I believe he was a Chinese trained MD and Chinese family/ TCM trained practitioner of acupucture , herbs, tui na, etc. He died after having 60 to 70 years of practice. He was partly talking about the hands on skills of a practitioner of Chinese medicine. Talking about western medicine has left the personel touch realm and is more mechanical- which is good for western medicine.

Meaning he had a lot more going for him then the vast majority of American/European trained practioners of TCM, meridian therapy, 5 elements. The majority of us are not medical docters who went to Chinese medicne school.

If a person treats a broken hand , claims to be an acupuncturist, and doesn't diagnose the broken hand..well that's prettty bad. Chinese medicine has excellent methods of diagnosing medical problems. Palpation, like hara diagnosis, pulse taking, can give a load of info. That's the point of the 10 asking questions.

The point is most people just out of TCM school are not at a high level of skill. OF COURSE it's good to work in conjunction with western medicine, get labs, x-rays. It's all useful . Another aspect is to be humble and not think you can do more then you can really do. In acupuncture school you work, possibly , with difficult cases, and always are supervised by a licensed practitioner, most schools want Chinese who are dual docs, to confirm diagnosis, treatment protocols. The point is they have experience, you don't. You're still in school. Then you get out of school, and when the time comes time tells.

Even with 20 years of western medicine, to think you can do acupuncture tui na whatever after taking a 100 hour course is silly. Even a typical acupuncture/herb/tui na school has a year or more of supervised internships.

So, I feel Chinese medicine can stand alone for a lot of medical issues but you have to be honest in your skill in treating the problem. And using info from western medicine is CLEARLY helpful!!!!!!!

Pilgrim Steve

[AJM]

Even with 20 years of western medicine, to think you can do acupuncture tui na whatever after taking a 100 hour course is silly. Even a typical acupuncture/herb/tui na school has a year or more of supervised internships.



Pilgrim Steve[/QUOTE]

I'd add those four month courses in Reiki to this as well. From my experience it takes years to be able to sense and maniputate the chi flow of someone without making the problem worse. I've had to use tui na to relieve migraines on a few people that had stale chi stuck in their head after going to rather unexperienced practitioners.

[lonewolf]

Even with 20 years of western medicine, to think you can do acupuncture tui na whatever after taking a 100 hour course is silly. Even a typical acupuncture/herb/tui na school has a year or more of supervised internships.



Pilgrim Steve

I'd add those four month courses in Reiki to this as well. From my experience it takes years to be able to sense and maniputate the chi flow of someone without making the problem worse. I've had to use tui na to relieve migraines on a few people that had stale chi stuck in their head after going to rather unexperienced practitioners.[/QUOTE]

while i totally have to disagree with the first statement i do agree with the second half. first i would check out the midwest college of TCM in chicago and wisconsin. there program is 4-6 years and is full time. doing acupuncture after a 100 hours is bull.
as for the reiki classes i have run into people that do free reiki sessions at churches and such for donations. these people learn it at some seminar for a day and then go around trying to work on people. they get away with it classifing it as massage and people don't know any better. my wife is a certified massage therapist and went to school for two years to get her degree and to one of the best schools in the country KCHA. the idea of just anybody doing reiki or massage of any kind it crap and people should be worried about it. :cool:

[pilgrimsunwukun]

Exactly my point wolf. MD's have a course that gives them the ability to be an acupuncture mechanic-1oo hours or so of training over several weekends. They clearly know a and p, etc. But what such programs lack are the hours of clinical experience with a licensed acupuncturist such as what happens in acupuncture schools. Such is apparent since there is a trend for MD's to enroll into TCM schools.


Or Dr. Wei Liu's advanced needling ceu class - he's up there is Wisconsin,possible the windy city too; if you never had those techniques before, think you have them after a weekend seminar? No you don't. Think you can take Tom Bisio's tui na classes, with only being a licensed massage therapist, and think you have those skills down? No, it's a start.

Even with graduating from acupuncture school, do you think you're good? Well maybe pretty good but ask anyone who's done the dipl. ac., master's programs, and ask if they haven't become way better with years of practice.

That's the point, just because you have a license.....it's like a black belt.....it just means you're ready for more schooling. In Asian cultures, beginners apprentice 5, 10 15, years before they get to school.

I remember Dr. Ma , a man with 50 years of practice saying he was unsure about a particular case since he had only treated the condition 200 times or so. That's what I'm talking about, trained , humble, still learning.

Steve a la pilgrim/pilgrimsuwukung

[PlumDragon]

there is nothing that TCM can accomplish that can't be adequately described with the already extant western anat/physiol knowledge that is available, it's just a matter of understanding how the organism functions in an at times non-linear, complex systems based context...
Non-linear systems and complex adaptive systems are subjects of considerable interest in research circles today, and in my experience, a study of significant mathematical, chemical, and sometimes counter-intuitive principles. While there is much thrust in research in these areas (not just with human landscape but with other living organisms, and even in non-related areas such as control system engineering), much like AI, these fields are in fact still in their infancy, IMO.

I agree though, but only to a degree. While its reasonable to say there is *no* topic that cant be adequately described either now or at some point in the future, the low-level details are where we fall short. We still have a great deal to learn...

[qiphlow]

2) despite the fx., TCM helped, meaning that the acup. was able to help mediate the local inflammatory process and decrease the pain appreciably; consequently, there has been some study on the effects of TCM on fx. management, such as casting in a removeable splint apparatus so that periodic acup. and gentle ROM could be administered while the fx. was healing - if i recall correctly, the sample group did markedly better than the controls



hey, this is interesting--if you can, please PM me as to where i can find more info on this. i'm an ortho tech by trade.

and on another note: i think that TCM has a much better system for diagnosis and treatment in that TCM takes a holistic approach to diagnosis and treatment. of course, individual practitioner skill will vary (as with anything), but from a strictly theoretical standpoint, TCM has a very good system in place. Western medicine is moving toward this holistic approach, albeit very slowly...
i think we have problems because of not very many "reputable" studies being done as to the efficacy of TCM for the big diseases like cancer, diabetes, etc. also qi is hard to quantify for the purposes of "objective" research.

[qiphlow]

and i might also add that there's alot of dissatisfaction with the medical "industry" these days--pills, pills, and more pills, but your main problem never goes away...
patients expect that the doctor will know how to cure them, but alot of doctors will just focus on getting rid of symptoms or blow the patient off entirely if nothing abnormal shows up on diagnostic tests. this is caused in part by the drug companies and the fda only approving certain drugs or other treatments, and partly by the patients for not taking enough interest in their own healthcare (perhaps so they have someone to sue if their expectations aren't met), and partly by the perception in the west that only your doctor knows what's good for you.
we may need to change our methodology for conducting research if we're to prove to ourselves that TCM "works" (and qigong, taiji, reiki, etc. for that matter).
again, alot of these eastern methods for treating problems produce subjective results, and we want objective results that we can quantify before we believe it's real. how do we do it?

[cjurakpt]

Non-linear systems and complex adaptive systems are subjects of considerable interest in research circles today, and in my experience, a study of significant mathematical, chemical, and sometimes counter-intuitive principles. While there is much thrust in research in these areas (not just with human landscape but with other living organisms, and even in non-related areas such as control system engineering), much like AI, these fields are in fact still in their infancy, IMO.

I agree though, but only to a degree. While its reasonable to say there is *no* topic that cant be adequately described either now or at some point in the future, the low-level details are where we fall short. We still have a great deal to learn...

good points

in terms of the body, the behavior of the connective tissue matrix in context of tensegrity principles (continuous tension / discontinuous compression) is a great place to start evaluating how the organism responds to stress (kinetic as well as non-physical) in a non-linear fasion; for example, how inserting acupuncture needles in different areas can create changes in pelvic bone alignment (described by Flaws in one of his old Dit Da books) - changes in both neuromuscular tone and fascial tension allow the organism can "self-correct" bsed on some intrinsic programed drive towards homeostasis

that said, I agree that the field is relatively new; however, its roots go back to texts such as "Growth & Form" by English mathematician D'Arcy Thompson (1917) and is developed further by others such as Theodor Schwenk in "Sensitive Chaos" (both looking at patterns of complexity and chaos in deiiferent ways); Thompson, for example, states that:
"we rise from the conception of form to an understanding of the forces which gave rise to it; and in the representation of form and in the comparison of kindred forms, we see in the one case a diagram of forces in equilibrium, and in the other case we discern the magnitude and the direction of the forces which have sufficed to convert the one form into the other." (p.270)
point is that he is trying to understand how the complex interractions of biological forces combine to create different end-forms - in essence, chaos / complexity looks at "simple" forms, static or dynamic, and attempts to understand what underlies them; in reagrds to TCM, for example, the practitioner looks at "form" in order to understand "function" and sees how the latter operates to impact the former; of course, we also know this as yin (form) and yang (function);

so there's some exciting stuff going on out there...

[cjurakpt]

Even with 20 years of western medicine, to think you can do acupuncture tui na whatever after taking a 100 hour course is silly. Even a typical acupuncture/herb/tui na school has a year or more of supervised internships
true on one level - which is that it is impossible to use acupuncture in context of TCM theory and practice; however, these courses typically are a aundry list of recepie's of needling patterns to address specific "diagnoses" from a western perspective ("ok, if you have apt. w/ulcerative collitis, do this"); of course, this is NOT TCM at all - and it's ot taking into account unique nature of each person;


MD's have a course that gives them the ability to be an acupuncture mechanic-1oo hours or so of training over several weekends. They clearly know a and p, etc. But what such programs lack are the hours of clinical experience with a licensed acupuncturist such as what happens in acupuncture schools. Such is apparent since there is a trend for MD's to enroll into TCM schools.
Harvard Med School recently started offereing a year-long weekly intensive training for MD's in TCM (a lot of correspondence, weekly on site); it's actually run in part by a PM&R doc I knew when I was a PT student at Columbia, very nice guy, studied taijiquan etc.


I'd add those four month courses in Reiki to this as well.

as for the reiki classes i have run into people that do free reiki sessions at churches and such for donations. these people learn it at some seminar for a day and then go around trying to work on people. they get away with it classifing it as massage and people don't know any better. my wife is a certified massage therapist and went to school for two years to get her degree and to one of the best schools in the country KCHA. the idea of just anybody doing reiki or massage of any kind it crap and people should be worried about it. :cool:
don't get me stated on Reiki - when someone tells me they are a Reiki master, the joke is "oh, so you stayed for the WHOLE weekend, huh?"; point is, regardless of the modality itself, there's a place for "intuitive" stuff - and it's not with clinical population, unless it's combined with solid training in a licensed healthcare profession; otherwise, stick to playing with your friends and relatives; BTW, in NY they would be in hot water if they called it massage, since that's a regulated term - they use bodywork or energy work to get around that - again, if they want to be hobyists, it's fine; as soon as you treat the general public and aren't licesensed, i have a huge issue with that...


From my experience it takes years to be able to sense and maniputate the chi flow of someone without making the problem worse. I've had to use tui na to relieve migraines on a few people that had stale chi stuck in their head after going to rather unexperienced practitioners.
agreed: I've seen similar situations with people who've had "light touch" cranialsacral or other energy work, who get "stuck", and need some good old fasioned manipulation / deep fascial relaese work to "wring out" the stuck stuff (porbably congested lymphatics and a confused as hell autonomic nervous system which got all irritated by the light touch that it wasn't able to interpret / process appropriately); for the migraines, I would say that they might have had some reflexive maladpatations of the sub-occipitals, which regulate the postural and occular systems to a significant degree, and often get "stuck" in a hypertensive adaptation when you "irritate" the system - so the tuina makes senses that it would resolve that (either applied locally or elsewhere), since it give th body a very firm, solid reference / fulcrum off of which to re-organize itself autonomically and posturally

[PlumDragon]

that said, I agree that the field is relatively new; however, its roots go back to texts such as "Growth & Form" by English mathematician D'Arcy Thompson (1917) and is developed further by others such as Theodor Schwenk in "Sensitive Chaos" (both looking at patterns of complexity and chaos in deiiferent ways); Thompson, for example, states that:
"we rise from the conception of form to an understanding of the forces which gave rise to it; and in the representation of form and in the comparison of kindred forms, we see in the one case a diagram of forces in equilibrium, and in the other case we discern the magnitude and the direction of the forces which have sufficed to convert the one form into the other." (p.270)
point is that he is trying to understand how the complex interractions of biological forces combine to create different end-forms - in essence, chaos / complexity looks at "simple" forms, static or dynamic, and attempts to understand what underlies them; in reagrds to TCM, for example, the practitioner looks at "form" in order to understand "function" and sees how the latter operates to impact the former; of course, we also know this as yin (form) and yang (function);

so there's some exciting stuff going on out there...
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.

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.

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...

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.

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."

[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? :mad:

[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? :mad:


Quite easily.