Misconceptions about Traditional Chinese Medicine

Introduction

Although acupuncturists, Chinese herbalists, TCM practitioners, and Doctors of Oriental Medicine (or whatever aliases trained and licensed healthcare professionals certfied by the NCCAOM go by based on the state(s) in which they are licensed to practice) are becoming increasingly accepted by healthcare consumers (i.e. patients, the general public) and a few medical doctors interested in complementary and alterrnative medicines (CAM), there is still much misunderstanding of our particular field of medicine across all spectrums, from research entities and governing bodies to healthcare consumers and providers. In this article, I hope to bring to the forefront some of the misconceptions and misunderstandings about acupuncture and traditional Chinese herbal medicine in the U.S. today.

Healthcare Consumers

There is no doubt that most Americans are becoming increasingly dissatisfied with the quality and affordability of traditional allopatic healthcare, and many patients are frustrated by the lack of time they are able to spend with their medical doctors. They feel that their medical problems are not being properly addressed. Many are wary of taking pharmaceutical products to "hide" their symptoms, rather than treat their underlying problem, and others are tired of taking medications to deal with the side effects of their other medications. A vast majority of people take vitamin and/or herbal supplements that they buy over-the-counter at drug stores, retail stores, and health food stores. Many do not see a need to inform their medical doctors that they are taking these products (mostly because the medical doctor probably knows very little about the supplement anyway). Patients who have educated themselves about their own health conditions often seek help from naturopaths, homeopaths, doctors of oriental medicine, and others. Some of these patients may inform their medical doctors that they are seeking advice from these other practitioners, while others also choose to not communcate this information to the medical doctors for verying reasons. Likewise, they may not communicate information about pharmaceutical usage to their acupuncturist, homeopath, herbalist, etc. There is typically no direct communication between Chinese herbalists and their patients' medical doctors regarding the patient's care unless the Chinese herbalist is lucky enough to actually be working in the same clinic as a medical doctor.

Some patients of acupuncturists/Chinese herbalists/doctors of oriental medicine/TCM practitioners choose this form of therapy because they read about this form of medicine in a book, magazine article, newspaper, or brochure handed out by the herbalist, or because of a referral from a friend about its effectiveness, or some other route in which the patient became educated about the effectiveness of Traditional Chinese Medicine. These patients regard their acupuncturist as a health care professional, refer to them as their "doctor," and trust this professional to find out what is medically wrong with the patient and arrive an an effective treatment for the problem.

Other patients of acupuncturists/Chinese herbalists/doctors of oriental medicine/TCM practitioners regard us as mystical healers who can exorcise spiritual demons, perform spells, and cause miraculous cures of diseases believed by "doctors" to be terminal. These patients have misguided reasons for seeking the help of a TCM practitioner because acupuncture and chinese herbal therapy are NOT mystical, magical cures. Most acupuncturists/herbalists regard themselves as healthcare professionals -- especially since many years of medical education is required to enter the field as a practitioner. However, just as there are many "quacks" out there who are medical doctors, occasionally you may come across an acupuncturist/herbalist who is a "quack." Such practitioners may claim to be working within a spiritual realm, or they may utilize unorthodox forms of therapy that are not taught in the Traditional Chinese Medical texts. Such misconceptions about acupuncture and herbal medicine keep many potential patients from ever seeking our help. I wouldn't go to an acupuncturist or an herbalist either if I thought the person was going to cast a spell on me in order to get rid of my illness! It would be a waste of my time and money.

Healthcare Professionals

Most medical doctors don't receive any exposure to acupuncture or herbal medicine (or nutrition) during medical school, so they have no clue as to what a TCM practitioner might do, say, know, or believe. Those few who are lucky enough to have any exposure at all to a non-allopathic form of medicine get relatively very little information from the experience. When I was doing clinical rotations at the Pacific College of Oriental Medicine in San Diego, occasionally a medical student from the University of California at San Diego (UCSD) would hang out in the clinic for a four hour shift as part of an elective course in complementary medicine offered at UCSD. They got to witness acupuncture treatments, watch assistants prepare herbal formulas in the herbal pharmacy, and maybe even get an acupuncture treatment themselves. Some were lucky enough to follow an intern or supervisor who had plenty of time to explain Chinese medical theories to them, or give them information about reasons they may want to send a particular patient to a TCM practitioner. Others were less lucky, either observing during a "dead" shift in which there were no patients, or on an incredibly hectic shift in which no one really had any time to speak with them about what was going on. The majority of those UCSD students probably left our clinic after four hours of nothing but a play day.

The University of Arizona medical school has a program in integrative medicine. The program is for medical doctors only, and it includes a fellowship opportunity as well as continuing education courses on various things such as research conducted on the use of botanicals for menstrual cramps. Usage of single herbs in clinical trials is reviewed, and factors such as stress management and healthy diet are taken into account. The program's Integrative Medicine Clinic consists of three medical doctors. Though this program is a giant leap towards better patient care, it is still not hitting the overall picture. This is one reason why I went to an Oriental Medicine college instead of an allopathic medical school. I looked into the program at the University of Arizona medical school during my junior year as an undergrad at Hendrix College, and concluded that the program was still primarily allopathic with a few "bells and whistles" added on.

Researchers

There is a lack of modern research performed in a systematic way in the field of Traditional Chinese Medicine, regarding acupuncture and herbology alike. Most modern research groups studying Traditional Chinese Medicine consist of medical doctors instead of TCM doctors. This approach makes just as much sense to me as it would for dentists to conduct research on optometry. These studies often produce results such as "There was no difference between using sham acupuncture and acupuncture in subjective measurements of pain," and "There is no evidence to show that St. John's Wort treats depression." How is a medical doctor supposed to know what a "sham" acupuncture treatment is, and how are they supposed to know that St. John's Wort is not used in TCM (and nor do we usually prescribe single herbs for such a broad diagnosis such as "depression"). Poorly conducted studies on the usage of acupuncture and Chinese herbal medicine make headlines in mainstream news media, and this is the information most consumers and health care professionals receive. Many TCM practitioners are therefore not interested in conducting research, and most do not know how to go about doing a scientific study even if they were so inclined. It seems that a growing number of younger, newly licensed acupuncturists/herbalists are interested in doing research, without having any prestigious previous experiences to help land them a good position with a major research institution or medical college.

Conclusion

Though there has been a growth in acceptance by the general public in the usage of acupuncture and herbal medicine for the treatment and/or prevention of various medical problems, the field of Integrative Medicine (the usage of acupuncture, herbs, nutritional therapy, exercise, homeopathy, etc. ALONGSIDE allopathic care such as health screening, pharmaceuticals, surgery, etc.) still has much room for growth. The integration has not yet occurred, and acupuncturists/herbalists are still taking their seats at the back of the bus, drinking from the "other" fountain, and standing at the end of the line. We're still second-class citizens, often referred to by our first names instead of by our last names preceded by the title "Dr," and too often seen as a "last resort" person to go to when "nothing else works."

There are ways to help. As a healthcare consumer, you can join the Cochrane library's consumer network, and let them know you want acupuncture and herbal studies conducted by professionals who have specifically been trained in that field and certified by the NCCAOM. Go here: http://www.cochrane.org/consumers/contact.htm for more information and to download a membership form. As a Traditional Chinese Medicine practitioner, you can conduct quality research and/or join the Cochrane Collaboration as part of the review board, join a methods group, or one of the other entities at Cochrane. Also, communicate with medical doctors about any form of acupuncture or herbal care you are receiving or providing. Many medical doctors are now open to learning more about this emerging field.