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Thaddeus Jacobs wrote:

 

You

mentioned that "no TCM school in the entire country provides adequate training

to properly

order and interpret lab tests."This

is not the case. The CCM program at NCNM requires all students to

take the same lab dx courses that the ND's take.

correct me if I am wrong, but NCNM

CCM program only admits those with prior medical licenses or concurrent

ND students. The lab test training is actually part of the naturopathic

program, not the CCM program. In OR, the ordering of lab tests is

expressly forbidden for L.Ac.. You may have heard otherwise, but

ask the BME and you will get an earful if not provoke an investigation.

 

This

in fact would both meet the proposed new California standards as well as

the standards which you say don't exist.I

also disagree with you on your position that Chinese medicine pratitioners

should not be primary care providers nor perform lab testing and interpretation.

 

if you want to be forced to practice

western medicine, which might be fine for an ND like yourself. but

many others are just not interested in having our hands tied that way.

Plus as an ND, you cannot be licensed in CA, so you have an interest in

legally using your ND training in CA. I assume you would also support

inclusion of homeopathy in the CA law, for the same reason. while

you are certainly trained to do this properly, this position creates a

legal bind for the rest of us.

 

Perhaps

the training at the majority of Western TCM schools isn't quite up to the

resposibility as such but that doesn't mean that the situation can't be

improved.

and after we have training, I would

be all for it. I took NCNM's lab dx classes which means I know far

more about this most L.Ac. and I am not up to the task.

 

 

 

--

 

Chinese Herbal Medicine

 

(503) 771-9599

 

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Todd using laboratory test has nothing to do with being a primary care provider. I routinely order labs on pts taking herbs to make sure everything is ok. I have found over 15 cased of elevated LFT's over the last 12 yr. Just the other day I ordered studies on a patient with BPH that has been taking herbs for the last 6 months. The formula was fairly common and included vitalizing blood, draining damp heat and straightening K. The patient symptoms and signs greatly improved (including frequency, pressure, hasensy). The patient is being seen by an MD but these days (HMO;s) routine blood test are not ordered. The MD was happy for the Pt since his symptoms greatly improved. On my routine blood tests (which I order on every patient taking long-term herbs) the patient showed increased SGOT, and Creatinine. Even though the Patient is feeling much better his tongue and pulse greatly improved there is something going on that with my limited ability to use TCM dx I did not see. I am willing to bat the majority of other TCM practitioners would not as well. To protect my self I insisted that he will see a urologist.

The main focus of my practice is musculoskeletal medicine. Every day I need to order X-rays, MRI's bonescans etc. These are not only important from a biomedical perspective but I find them extremely helpful for my OM practice. For example, I often see patient with chronic low back pain that have failed PT, Chiropractors, medications, injections, acupuncture and herbs etc. A large % or these patients have internal disc disruption that has never been diagnosed by any of their providers. I often order a discogram to verify the diagnosis (the only way to really know). Their TCM Dx can be all over the map. They may have K S/S, Blood stasis S/S, Cold S/S, Damp, Damp heat, Sp, H, etc. For many years I have followed TCM pattern discrimination in deciding what herbs, acupuncture and body work to prescribe for these patients and I was not very affective, as are many of the TCM and OM practitioners I have followed in my training (in US, Japan and China). And now that I see many patients that have been through the mill, including TCM, I know that following TCM principals for this population does not work very well. Regardless of their TCM Dx they do best with clearing phlegm-damp-heat and vitalizing the blood herbs. Depending on the stage of soft tissue degenerative cascade other herbs can be added (including some based on TCM S/S). I also make many of my needling choices based on functional/structural modern information for which studies can be helpful. I think a dividing line between TCM and modern medicine comes from people need for orthodoxy (tribal behavior) and not from thinking about the patient best interest. I do not believe their is A TCM treatment of A Biomedical diagnosis, that can completely bypass pattern decrimination, but information from modern understanding can be extremely helpful both for safety and clinical use.

I do not advocate the abandonment of OM principals. The future development of OM should not be achieve only by looking at past history. If it does then we are practicing religion not medicine. I strongly support the right of LAc to order modern lab tests and definitely agree that more training is needed at schools.

Alon Marcus

 

-

cha

Friday, August 25, 2000 11:08 AM

lab tests

Thaddeus Jacobs wrote:

You mentioned that "no TCM school in the entire country provides adequate training to properly order and interpret lab tests."This is not the case. The CCM program at NCNM requires all students to take the same lab dx courses that the ND's take. correct me if I am wrong, but NCNM CCM program only admits those with prior medical licenses or concurrent ND students. The lab test training is actually part of the naturopathic program, not the CCM program. In OR, the ordering of lab tests is expressly forbidden for L.Ac.. You may have heard otherwise, but ask the BME and you will get an earful if not provoke an investigation. This in fact would both meet the proposed new California standards as well as the standards which you say don't exist.I also disagree with you on your position that Chinese medicine pratitioners should not be primary care providers nor perform lab testing and interpretation. if you want to be forced to practice western medicine, which might be fine for an ND like yourself. but many others are just not interested in having our hands tied that way. Plus as an ND, you cannot be licensed in CA, so you have an interest in legally using your ND training in CA. I assume you would also support inclusion of homeopathy in the CA law, for the same reason. while you are certainly trained to do this properly, this position creates a legal bind for the rest of us. Perhaps the training at the majority of Western TCM schools isn't quite up to the resposibility as such but that doesn't mean that the situation can't be improved. and after we have training, I would be all for it. I took NCNM's lab dx classes which means I know far more about this most L.Ac. and I am not up to the task. -- Director Chinese Herbal Medicine (503) 771-9599 Chinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

 

-

cha

Friday, August 25, 2000 11:08 AM

lab tests

Thaddeus Jacobs wrote:

You mentioned that "no TCM school in the entire country provides adequate training to properly order and interpret lab tests."This is not the case. The CCM program at NCNM requires all students to take the same lab dx courses that the ND's take. correct me if I am wrong, but NCNM CCM program only admits those with prior medical licenses or concurrent ND students. The lab test training is actually part of the naturopathic program, not the CCM program. In OR, the ordering of lab tests is expressly forbidden for L.Ac.. You may have heard otherwise, but ask the BME and you will get an earful if not provoke an investigation. This in fact would both meet the proposed new California standards as well as the standards which you say don't exist.I also disagree with you on your position that Chinese medicine pratitioners should not be primary care providers nor perform lab testing and interpretation. if you want to be forced to practice western medicine, which might be fine for an ND like yourself. but many others are just not interested in having our hands tied that way. Plus as an ND, you cannot be licensed in CA, so you have an interest in legally using your ND training in CA. I assume you would also support inclusion of homeopathy in the CA law, for the same reason. while you are certainly trained to do this properly, this position creates a legal bind for the rest of us. Perhaps the training at the majority of Western TCM schools isn't quite up to the resposibility as such but that doesn't mean that the situation can't be improved. and after we have training, I would be all for it. I took NCNM's lab dx classes which means I know far more about this most L.Ac. and I am not up to the task. -- Director Chinese Herbal Medicine (503) 771-9599 Chinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

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Alon:

 

I read through your post a couple of times and determined that you

seem quite comfortable with the lab test and diagnostic scans you

order. I can see where they are helpful to you.

 

What makes me very uncomfortable is giving these " rights " to all

licensed acupuncturists. With rights come responsibilities. I do not

believe that we as a profession are in any way ready to assume the

responsibilities that come with these rights. And I am not sure that

we ever will be or should be given them.

 

The function of these tests seems to be in making biomedical

diagnoses. I was not trained to make biomedical diagnoses and I do

not believe that is part of the curriculum at any TCM school in this

country. The one course referred to in previous posts does not seem

sufficient to provide the necessary expertise.

 

I think looking at the cause and effect relationships related to our

treatment is excellent, but with the right to order a test to do that

comes the responsibility to identify other problems these test

results would reveal to the average biomedical diagnostician.

While you may do that successfully, I think most licensed

acupuncturists I know would fail miserably at this.

 

My current belief is in one of integration. If we want access to that

type of information, we should align ourselves with physicians who

can appropriately assume the responsibilities that go beyond our

training and therefore beyond the scope of our practice.

 

As for what is best for the patient. I believe that patients should

be assured that the practioners they choose will be bound to stay

within their training. While each of us has unique skills and

abilities we have developed, there needs to be constraint of the

profession as a whole to stay within the scope of practice defined by

the license held. Those responsibilities come with the right to be

licensed.

 

That may be tribal behavior, but right now, I think TCM needs to be a

tribe.

 

Michael Buyze, L.Ac.

Appleton, WI

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August 26, 2000

can appropriately assume the responsibilities that go beyond our training and therefore beyond the scope of our practice.

>>>>>First, the problem, especially in musculoskeletal medicine, is that the medical community is often not up to date and quite deficient in using their own technology. If one can find a medical practitioner that is well trained and knows how to work w/ complementary practitioners then that is the best situation. Unfortunately not common.

I do not see TCM practitioners ordering tests they do not understand, I would be interested to hear if you do. However, some tests can be used for screening and if abnormal can be referred to the appropriate practitioner. Unless we as a profession learn to use modern technology we will fall victim to situation were rare cases with complications will result in our loss of our ability to prescribe our medicine. When some MD makes a ton of noise on one patient he has seen w/ complications, do to herbs, and we do not have enough clinical information to rebut, we will loose. You can not say our medicine is encient and we know better. We can not afford leaving the future of OM to the medical establishment. We must bring the profession of OM to the 21-century or we will see it being taking over or despair. Alon Marcus

 

-

Michael Buyze

Saturday, August 26, 2000 6:34 AM

Re: Lab Tests

Alon:I read through your post a couple of times and determined that you seem quite comfortable with the lab test and diagnostic scans you order. I can see where they are helpful to you.What makes me very uncomfortable is giving these "rights" to all licensed acupuncturists. With rights come responsibilities. I do not believe that we as a profession are in any way ready to assume the responsibilities that come with these rights. And I am not sure that we ever will be or should be given them.The function of these tests seems to be in making biomedical diagnoses. I was not trained to make biomedical diagnoses and I do not believe that is part of the curriculum at any TCM school in this country. The one course referred to in previous posts does not seem sufficient to provide the necessary expertise. I think looking at the cause and effect relationships related to our treatment is excellent, but with the right to order a test to do that comes the responsibility to identify other problems these test results would reveal to the average biomedical diagnostician. While you may do that successfully, I think most licensed acupuncturists I know would fail miserably at this.My current belief is in one of integration. If we want access to that type of information, we should align ourselves with physicians who can appropriately assume the responsibilities that go beyond our training and therefore beyond the scope of our practice. As for what is best for the patient. I believe that patients should be assured that the practioners they choose will be bound to stay within their training. While each of us has unique skills and abilities we have developed, there needs to be constraint of the profession as a whole to stay within the scope of practice defined by the license held. Those responsibilities come with the right to be licensed.That may be tribal behavior, but right now, I think TCM needs to be a tribe.Michael Buyze, L.Ac.Appleton, WIChinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

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, <alonmarcus@w...> wrote:

..

> The main focus of my practice is musculoskeletal medicine. Every

day I need to order X-rays, MRI's bonescans etc. These are not only

important from a biomedical perspective but I find them extremely

helpful for my OM practice. For example, I often see patient with

chronic low back pain that have failed PT, Chiropractors,

medications, injections, acupuncture and herbs etc. A large % or

these patients have internal disc disruption that has never been

diagnosed by any of their providers. I often order a discogram to

verify the diagnosis (the only way to really know). Their TCM Dx can

be all over the map. They may have K S/S, Blood stasis S/S, Cold S/S,

Damp, Damp heat, Sp, H, etc.

 

Alon

 

Upon what basis of experience or training do you interpret lab test

and

xrays? I have formally studied xray dx and lab dx at naturopathic

college and have worked with physicians in my clinic my whole career.

 

I am pretty good at lab test analysis, basic stuff, but suck at xray

dx. What you have not addressed is the liability that comes from

having to do lab tests to cover your butt. I am all for lab test

privileges for the very reasons you state, but as a profession, we

are

not trained to do this, which is both ethically and legally suspect,

as

I said. If we get the training, grant the privilege.

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<alonmarcus@w...> wrote:

 

>>> A large % or

these patients have internal disc disruption that has never been

diagnosed by any of their providers. <<<

 

How does an internal disc disruption guide your therapy assuming that

you're using the traditional arsenal?

 

--

Al Stone L.Ac.

<AlStone

http://www.BeyondWellBeing.com

 

Pain is inevitable, suffering is optional.

 

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, <alonmarcus@w...> wrote:

> August 26, 2000

 

>

> I do not see TCM practitioners ordering tests they do not

understand, I would be interested to hear if you do.

 

 

gee, I have rarely known a TCM practitioner who understood any lab

tests at all. Come clean, Alon, you must have additional training in

this area.

 

and amen to Mike Byuze. once again, I support the inclusion of lab

testing in our scope as soon as we have state mandated training

equivalent to MD's in this area. FYI, chiro's and NDs get as much or

more lab testing education than MD's, so why shouldn't we? with all

due respect, ordering lab tests without extensive biomedical training

borders on malpractice in my opinion.

 

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----- Original Message

x-rays? I have formally studied x-ray dx and lab dx at naturopathic college and have worked with physicians in my clinic my whole career.I am pretty good at lab test analysis, basic stuff, but suck at xray dx. What you have not addressed is the liability that comes from having to do lab tests to cover your butt. I am all for lab test privileges for the very reasons you state, but as a profession, weare not trained to do this, which is both ethically and legally suspect,as I said. If we get the training, grant the privilege. >>>> First, remember that all studies usually come with reports. I never try to make a medical interpretation of X-rays or other studies (although I know how too). I always have a Board certified radiologist read X-rays first. However, there is much information on posture and function that a radiologist does not know how, or interested in looking for. With MRIs studies of the spine for example, radiologist never look for HIZ on T2 cuts, and do not include them in reports even though they can suggest disc fissures. Personally, I have studied (1-3 times a week for 5 years) with a MD specializing in Orthopedic Medicine. When I was in school and in China (were lab work was routine in our TCM hospital) I made it a point to try to understand all the information that was presented to me. Therefore, I studied all lab work needed to diagnose a disease that we were covering at school.

I believe my liability is less if I order studies and refer the patient out if abnormalities are found, than if I miss a cancer or alike.

Alon -----

 

Saturday, August 26, 2000 10:49 AM

Re: lab tests

, <alonmarcus@w...> wrote:.> The main focus of my practice is musculoskeletal medicine. Everyday I need to order X-rays, MRI's bonescans etc. These are not onlyimportant from a biomedical perspective but I find them extremelyhelpful for my OM practice. For example, I often see patient withchronic low back pain that have failed PT, Chiropractors,medications, injections, acupuncture and herbs etc. A large % orthese patients have internal disc disruption that has never beendiagnosed by any of their providers. I often order a discogram toverify the diagnosis (the only way to really know). Their TCM Dx canbe all over the map. They may have K S/S, Blood stasis S/S, Cold S/S,Damp, Damp heat, Sp, H, etc.AlonUpon what basis of experience or training do you interpret lab testand xrays? I have formally studied xray dx and lab dx at naturopathic college and have worked with physicians in my clinic my whole career.I am pretty good at lab test analysis, basic stuff, but suck at xray dx. What you have not addressed is the liability that comes from having to do lab tests to cover your butt. I am all for lab test privileges for the very reasons you state, but as a profession, weare not trained to do this, which is both ethically and legally suspect,as I said. If we get the training, grant the privilege. Chinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

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How does an internal disc disruption guide your therapy assuming thatyou're using the traditional arsenal?

 

>>>>If a disc fissure is the cause of the patients symptoms usually the pain is inflammatory and immunological (which often can not be ascertained from a TCM evaluation alone). I have found that these patients do better on the herbs I mentioned before than on individualized TCM pattern formulas.

When using acupuncture w/ disc derangement's for example, I find that positioning the patient in such a way that aids the return of the disc fragment, or shift the nucleus in the desired direction, aids the patient much more than just using needles and the patient has less flare-ups and treatment course greatly improves. If the pain patterns or other evaluation allow me to ascertain a specific joint, ligament or muscle involvement I can choose specific areas, points, trigger etc. to needle or treat w/ body work. There are many more examples but this is not the place

Alon

 

-

Al Stone

Saturday, August 26, 2000 12:02 PM

Re: Re: lab tests

<alonmarcus@w...> wrote:>>> A large % orthese patients have internal disc disruption that has never beendiagnosed by any of their providers. <<<How does an internal disc disruption guide your therapy assuming thatyou're using the traditional arsenal?-- Al Stone L.Ac.<AlStonehttp://www.BeyondWellBeing.comPain is inevitable, suffering is optional. Chinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

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soon as we have state mandated training equivalent to MD's in this area. FYI, chiro's and NDs get as much or more lab testing education than MD's, so why shouldn't we? with all due respect, ordering lab tests without extensive biomedical training borders on malpractice in my opinion.>>>>Amen. This would do more to help us protect our future than any other increase in TCM training in school. I believe the practice of medicine is a serious choise one makes and if one chooses to practice it is incumbent on me to receive all the training I can in any way I can, to improve my abilities to treat responsibly. The study of modern lab and imaging is not that difficult and we should at least know as much as a PAs. In our clinics we should incorporate these just as it is done in China. That is the only responsible way to practice medicine in the 21-century.

Alon

 

-

 

Saturday, August 26, 2000 12:54 PM

Re: Lab Tests

, <alonmarcus@w...> wrote:> August 26, 2000> > I do not see TCM practitioners ordering tests they do notunderstand, I would be interested to hear if you do. gee, I have rarely known a TCM practitioner who understood any lab tests at all. Come clean, Alon, you must have additional training in this area.and amen to Mike Byuze. once again, I support the inclusion of lab testing in our scope as soon as we have state mandated training equivalent to MD's in this area. FYI, chiro's and NDs get as much or more lab testing education than MD's, so why shouldn't we? with all due respect, ordering lab tests without extensive biomedical training borders on malpractice in my opinion.ToddChinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

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Alon, I really respect your work and reputation in your specialty. However, it is an exception (orthopedic acupuncture and herbal medicine) from the practice of Chinese medicine, which is, that from the outset, a hybrid of biomedicine with Chinese medical technology and ideas, but not theoretically. There is nothing wrong with additional training in biomedical specialties, lab tests, etc., but they cannot replace a grounding in Chinese medical theory and the classical texts. What is going to protect our future is to walk our walk, talk our talk, study study study and practice Chinese medicine. There is nothing religious about this, it is just common sense. None of us have mastered our profession, because what we have gotten to study is a small piece of the medical tradition, we are the first generation of Western practitioners. I find it presumptuous that you and so many others can judge the value and worth of a vast system of medicine that we have only begun to scratch the surface of. Unless we greatly improve Chinese medical training, and the texts upon which it is based, and the treasure chest of specialties such as pediatrics, gynecology, and orthopedics, we will come to premature conclusions, as you have done, that biomedical knowledge is the key to our survival as a profession. But, I, for one, would beg to disagree.

 

 

 

 

 

 

on 8/26/00 2:12 PM, alonmarcus at alonmarcus wrote:

 

soon as we have state mandated training

equivalent to MD's in this area. FYI, chiro's and NDs get as much or

more lab testing education than MD's, so why shouldn't we? with all

due respect, ordering lab tests without extensive biomedical training

borders on malpractice in my opinion.

 

>>>>Amen. This would do more to help us protect our future than any other increase in TCM training in school. I believe the practice of medicine is a serious choise one makes and if one chooses to practice it is incumbent on me to receive all the training I can in any way I can, to improve my abilities to treat responsibly. The study of modern lab and imaging is not that difficult and we should at least know as much as a PAs. In our clinics we should incorporate these just as it is done in China. That is the only responsible way to practice medicine in the 21-century.

Alon

-

 

Saturday, August 26, 2000 12:54 PM

Re: Lab Tests

 

, <alonmarcus@w...> wrote:

> August 26, 2000

 

>

> I do not see TCM practitioners ordering tests they do not

understand, I would be interested to hear if you do.

 

 

gee, I have rarely known a TCM practitioner who understood any lab

tests at all. Come clean, Alon, you must have additional training in

this area.

 

and amen to Mike Byuze. once again, I support the inclusion of lab

testing in our scope as soon as we have state mandated training

equivalent to MD's in this area. FYI, chiro's and NDs get as much or

more lab testing education than MD's, so why shouldn't we? with all

due respect, ordering lab tests without extensive biomedical training

borders on malpractice in my opinion.

 

 

 

Chinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

 

 

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wrong with additional training in biomedical specialties, lab tests, etc., but they cannot replace a grounding in Chinese medical theory and the classical texts. What is going to protect our future is to walk our walk, talk our talk, study study study and practice Chinese medicine. There is nothing religious about this, it is just common sense. None of us have mastered our profession, because what we have gotten to study is a small piece of the medical tradition,

>>>>many of my conclusions followed a stay in a TCM hospital in China. I hope I saw well train Dr. Several had great reputation.

I also think it is imperative we master our profession. However, to be closed to the vast knowledge and experience of Modern medicine is foolish. If one assumes that the "Classics" have most of the answers then is the practice of religion. If one however studies all that is available and he is more capable of evaluating and incorporating all. Then I believe one practicing non-religiously. As far as our future I just dont want my to be upto biomedically (only) trained system.

Alon

 

-

 

Saturday, August 26, 2000 8:33 PM

Re: Re: Lab Tests

Alon, I really respect your work and reputation in your specialty. However, it is an exception (orthopedic acupuncture and herbal medicine) from the practice of Chinese medicine, which is, that from the outset, a hybrid of biomedicine with Chinese medical technology and ideas, but not theoretically. There is nothing wrong with additional training in biomedical specialties, lab tests, etc., but they cannot replace a grounding in Chinese medical theory and the classical texts. What is going to protect our future is to walk our walk, talk our talk, study study study and practice Chinese medicine. There is nothing religious about this, it is just common sense. None of us have mastered our profession, because what we have gotten to study is a small piece of the medical tradition, we are the first generation of Western practitioners. I find it presumptuous that you and so many others can judge the value and worth o! f a vast system of medicine that we have only begun to scratch the surface of. Unless we greatly improve Chinese medical training, and the texts upon which it is based, and the treasure chest of specialties such as pediatrics, gynecology, and orthopedics, we will come to premature conclusions, as you have done, that biomedical knowledge is the key to our survival as a profession. But, I, for one, would beg to disagree. on 8/26/00 2:12 PM, alonmarcus at alonmarcus wrote:

soon as we have state mandated training equivalent to MD's in this area. FYI, chiro's and NDs get as much or more lab testing education than MD's, so why shouldn't we? with all due respect, ordering lab tests without extensive biomedical training borders on malpractice in my opinion.>>>>Amen. This would do more to help us protect our future than any other increase in TCM training in school. I believe the practice of medicine is a serious choise one makes and if one chooses to practice it is incumbent on me to receive all the training I can in any way I can, to improve my abilities to treat responsibly. The study of modern lab and imaging is not that difficult and we should at least know as much as a PAs. In our clinics we should incorporate these just as it is done in China. That is the only responsible way to practice medicine in the 21-century.Alon

- Saturday, August 26, 2000 12:54 PM Re: Lab Tests , <alonmarcus@w...> wrote:> August 26, 2000> > I do not see TCM practitioners ordering tests they do notunderstand, I would be interested to hear if you do. gee, I have rarely known a TCM practitioner who understood any lab tests at all. Come clean, Alon, you must have additional training in this area.and amen to Mike Byuze. once again, I support the inclusion of lab testing in our scope as soon as we have state mandated training equivalent to MD's in this area. FYI, chiro's and NDs get as much or more lab testing education than MD's, so why shouldn't we? with all due respect, ordering lab tests without extensive biomedical training borders on malpractice in my opinion.ToddChinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

 

 

 

Chinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

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----that biomedical knowledge is the key to our survival as a profession

>>>>This knowledge has various advantages. For example, if we had thousands of lab tests showing that xi xin is safe in professional hands then we could fight the FDA much more effectively. The same applies across the board. Look at acupuncture it is the MD's that are publishing and heard by the system. At the FDA hearings 95% were MD's. The profession is yang and vulnerable.

Alon

 

-

 

Saturday, August 26, 2000 8:33 PM

Re: Re: Lab Tests

Alon, I really respect your work and reputation in your specialty. However, it is an exception (orthopedic acupuncture and herbal medicine) from the practice of Chinese medicine, which is, that from the outset, a hybrid of biomedicine with Chinese medical technology and ideas, but not theoretically. There is nothing wrong with additional training in biomedical specialties, lab tests, etc., but they cannot replace a grounding in Chinese medical theory and the classical texts. What is going to protect our future is to walk our walk, talk our talk, study study study and practice Chinese medicine. There is nothing religious about this, it is just common sense. None of us have mastered our profession, because what we have gotten to study is a small piece of the medical tradition, we are the first generation of Western practitioners. I find it presumptuous that you and so many others can judge the value and worth o! f a vast system of medicine that we have only begun to scratch the surface of. Unless we greatly improve Chinese medical training, and the texts upon which it is based, and the treasure chest of specialties such as pediatrics, gynecology, and orthopedics, we will come to premature conclusions, as you have done, that biomedical knowledge is the key to our survival as a profession. But, I, for one, would beg to disagree. on 8/26/00 2:12 PM, alonmarcus at alonmarcus wrote:

soon as we have state mandated training equivalent to MD's in this area. FYI, chiro's and NDs get as much or more lab testing education than MD's, so why shouldn't we? with all due respect, ordering lab tests without extensive biomedical training borders on malpractice in my opinion.>>>>Amen. This would do more to help us protect our future than any other increase in TCM training in school. I believe the practice of medicine is a serious choise one makes and if one chooses to practice it is incumbent on me to receive all the training I can in any way I can, to improve my abilities to treat responsibly. The study of modern lab and imaging is not that difficult and we should at least know as much as a PAs. In our clinics we should incorporate these just as it is done in China. That is the only responsible way to practice medicine in the 21-century.Alon

- Saturday, August 26, 2000 12:54 PM Re: Lab Tests , <alonmarcus@w...> wrote:> August 26, 2000> > I do not see TCM practitioners ordering tests they do notunderstand, I would be interested to hear if you do. gee, I have rarely known a TCM practitioner who understood any lab tests at all. Come clean, Alon, you must have additional training in this area.and amen to Mike Byuze. once again, I support the inclusion of lab testing in our scope as soon as we have state mandated training equivalent to MD's in this area. FYI, chiro's and NDs get as much or more lab testing education than MD's, so why shouldn't we? with all due respect, ordering lab tests without extensive biomedical training borders on malpractice in my opinion.ToddChinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

 

 

 

Chinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

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What is going to protect our future is to walk our walk, talk our talk, study study study and practice Chinese medicine

>>>I think there is a reason they learn both in China

Alon

 

-

 

Saturday, August 26, 2000 8:33 PM

Re: Re: Lab Tests

Alon, I really respect your work and reputation in your specialty. However, it is an exception (orthopedic acupuncture and herbal medicine) from the practice of Chinese medicine, which is, that from the outset, a hybrid of biomedicine with Chinese medical technology and ideas, but not theoretically. There is nothing wrong with additional training in biomedical specialties, lab tests, etc., but they cannot replace a grounding in Chinese medical theory and the classical texts. What is going to protect our future is to walk our walk, talk our talk, study study study and practice Chinese medicine. There is nothing religious about this, it is just common sense. None of us have mastered our profession, because what we have gotten to study is a small piece of the medical tradition, we are the first generation of Western practitioners. I find it presumptuous that you and so many others can judge the value and worth o! f a vast system of medicine that we have only begun to scratch the surface of. Unless we greatly improve Chinese medical training, and the texts upon which it is based, and the treasure chest of specialties such as pediatrics, gynecology, and orthopedics, we will come to premature conclusions, as you have done, that biomedical knowledge is the key to our survival as a profession. But, I, for one, would beg to disagree. on 8/26/00 2:12 PM, alonmarcus at alonmarcus wrote:

soon as we have state mandated training equivalent to MD's in this area. FYI, chiro's and NDs get as much or more lab testing education than MD's, so why shouldn't we? with all due respect, ordering lab tests without extensive biomedical training borders on malpractice in my opinion.>>>>Amen. This would do more to help us protect our future than any other increase in TCM training in school. I believe the practice of medicine is a serious choise one makes and if one chooses to practice it is incumbent on me to receive all the training I can in any way I can, to improve my abilities to treat responsibly. The study of modern lab and imaging is not that difficult and we should at least know as much as a PAs. In our clinics we should incorporate these just as it is done in China. That is the only responsible way to practice medicine in the 21-century.Alon

- Saturday, August 26, 2000 12:54 PM Re: Lab Tests , <alonmarcus@w...> wrote:> August 26, 2000> > I do not see TCM practitioners ordering tests they do notunderstand, I would be interested to hear if you do. gee, I have rarely known a TCM practitioner who understood any lab tests at all. Come clean, Alon, you must have additional training in this area.and amen to Mike Byuze. once again, I support the inclusion of lab testing in our scope as soon as we have state mandated training equivalent to MD's in this area. FYI, chiro's and NDs get as much or more lab testing education than MD's, so why shouldn't we? with all due respect, ordering lab tests without extensive biomedical training borders on malpractice in my opinion.ToddChinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

 

 

 

Chinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

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on 8/26/00 9:05 PM, alonmarcus at alonmarcus wrote:

 

----that biomedical knowledge is the key to our survival as a profession

>>>>This knowledge has various advantages. For example, if we had thousands of lab tests showing that xi xin is safe in professional hands then we could fight the FDA much more effectively. The same applies across the board. Look at acupuncture it is the MD's that are publishing and heard by the system. At the FDA hearings 95% were MD's. The profession is yang and vulnerable.

Alon

-----

 

 

 

It would be hard to disagree with what you have said here, Alon. It is just sweeping statements about the classics that get me. . . .for some reason, Ken Rose, Bob Felt, Bob Flaws, Todd and many others don't seem to be heard on one simple fact: the Chinese medical tradition is vast (like you say about biomedicine), and the contents of a four-year training is just wading in the kiddy pool, entry level competance is about what you get. We have just begun to translate, study and grasp this stuff. Certainly, we should have access to biomedical information, training, etc. . ..but it cannot replace the need to understand Chinese medicine as Chinese medicine. Unlike China, we do not have native language resources for 99% of the material, which puts us at great disadvantage. If we don't want a watered down TCM, we have to roll up our sleeves and get to work with it.

 

As far as studies for xi xin and the like, there is one word here: MONEY. We don't have the funds, resources and the like of the biomedical world. There are reams of studies in China, however, mostly, again, in Chinese.

 

Therein lies the dilemma.

 

All the best,

 

 

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China has a different agenda than alternative medical systems in the U.S.

There TCM is taught alongside biomedicine for the sake of the national health care system. The needs of the vast Chinese population practically, and the mad dash of China to catch up with Western science has led to a greater interest in biomedicine as THE standard of care.. . .TCM is used for its low cost, perceived simplicity, and history of efficacy, but it is not at an equal level of respect at the national level (at the present time). This changes at the local level, or outside the state system.

 

However, here the existence of acupuncture, herbal medicine and other alternative systems exists because of the percieved shortcomings of biomedicine, and the increasing occurances of iatrogenic illnesses. Biomedicine is perceived to be less effective with chronic disorders than trauma and emergency, and it is the PUBLIC who is demanding alternatives. While biomedicine will perhaps always be a part of modern health care, it is what Chinese medicine offers as an alternative that is important, not as just another department in a hospital. The state-level Chinese medicine model is not what is called for in the West, in my opinion.

 

 

 

 

on 8/26/00 9:06 PM, alonmarcus at alonmarcus wrote:

 

What is going to protect our future is to walk our walk, talk our talk, study study study and practice Chinese medicine

>>>I think there is a reason they learn both in China

Alon

-

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Back to lab tests: I order them, mainly as a convenience for my

patients. They generally know more about the " bio-medical " side

of their illness than I do. They get curious as to how they compare with

previous tests they got and it saves them an expensive trip to the

MD.

 

I tell them that their lab results (and I'm talking simple blood, SGOT

etc...) will have little consequence for the treatment plan that I give

them. They understand this.

 

I feel comfortable with the amount of " bio-medical " training

for the type of practice I do which is 99% TCM and 1 % voodoo.

 

doug

L.Ac. California

 

 

 

 

I am pretty good at lab test analysis, basic stuff, but suck at xray dx. What you have not addressed is the liability that comes

from having to do lab tests to cover your butt. I am all for lab

test privileges for the very reasons you state, but as a profession, we

are not trained to do this, which is both ethically and legally suspect,

as I said. If we get the training, grant the privilege.

 

 

 

 

Chinese Herbal Medicine, a voluntary organization of licensed

healthcare practitioners, matriculated students and postgraduate

academics specializing in Chinese Herbal Medicine, provides a variety of

professional services, including board approved online continuing

education.

 

 

 

 

 

 

Chinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

 

 

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We have just begun to translate, study and grasp this stuff. Certainly, we should have access to biomedical information, training, etc. . ..but it cannot replace the need to understand Chinese medicine as Chinese medicine. Unlike

>>>>I totally agree we need much more TCM training and exposure. But I have to go back to experience in China as well. And what I saw is much exaggerated statement and many questionable clinical outcomes for many disorders. I hope that with more classic knowledge as well as strong dedication we will be doing better.

As far as studies for xi xin and the like, there is one word here: MONEY. We don't have the funds, resources and the like of the biomedical world. There are reams of studies in China, however, mostly, again, in Chinese.

>>>>Here I am talking about clinical lab data. If we had the hundred of thousands pt w/ lab data we would be able to present it. This is not research data.

Alon

 

-

 

Saturday, August 26, 2000 10:22 PM

Re: Re: Lab Tests

on 8/26/00 9:05 PM, alonmarcus at alonmarcus wrote:

----that biomedical knowledge is the key to our survival as a profession>>>>This knowledge has various advantages. For example, if we had thousands of lab tests showing that xi xin is safe in professional hands then we could fight the FDA much more effectively. The same applies across the board. Look at acupuncture it is the MD's that are publishing and heard by the system. At the FDA hearings 95% were MD's. The profession is yang and vulnerable. Alon

 

 

----- It would be hard to disagree with what you have said here, Alon. It is just sweeping statements about the classics that get me. . . .for some reason, Ken Rose, Bob Felt, Bob Flaws, Todd and many others don't seem to be heard on one simple fact: the Chinese medical tradition is vast (like you say about biomedicine), and the contents of a four-year training is just wading in the kiddy pool, entry level competance is about what you get. We have just begun to translate, study and grasp this stuff. Certainly, we should have access to biomedical information, training, etc. . ..but it cannot replace the need to understand Chinese medicine as Chinese medicine. Unlike China, we do not have native language resources for 99% of the material, which puts us at great disadvantage. If we don't want a watered down TCM, we have to roll up our sleeves and get to work with it.As far as studies for xi xin and the like, there is one word here: MONEY. We don't have the funds, resources and the like of the biomedical world. There are reams of studies in China, however, mostly, again, in Chinese. Therein lies the dilemma.All the best,Chinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

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.. While biomedicine will perhaps always be a part of modern health care, it is what Chinese medicine offers as an alternative that is important, not as just another department in a hospital. The state-level Chinese medicine model is not what is called for in the West, in my opinion.>>>>that does not explain the clinical outcomes I saw in China

Alon

 

-

 

Saturday, August 26, 2000 10:30 PM

Re: Re: Lab Tests

China has a different agenda than alternative medical systems in the U.S. There TCM is taught alongside biomedicine for the sake of the national health care system. The needs of the vast Chinese population practically, and the mad dash of China to catch up with Western science has led to a greater interest in biomedicine as THE standard of care.. . .TCM is used for its low cost, perceived simplicity, and history of efficacy, but it is not at an equal level of respect at the national level (at the present time). This changes at the local level, or outside the state system.However, here the existence of acupuncture, herbal medicine and other alternative systems exists because of the percieved shortcomings of biomedicine, and the increasing occurances of iatrogenic illnesses. Biomedicine is perceived to be less effective with chronic disorders than trauma and emergency, and it is the PUBLIC who is demanding alternatives. While biomedicine will perhaps always be a part of modern health care, it is what Chinese medicine offers as an alternative that is important, not as just another department in a hospital. The state-level Chinese medicine model is not what is called for in the West, in my opinion.on 8/26/00 9:06 PM, alonmarcus at alonmarcus wrote:

What is going to protect our future is to walk our walk, talk our talk, study study study and practice Chinese medicine>>>I think there is a reason they learn both in ChinaAlon

- Chinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

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, <alonmarcus@w...> wrote:

 

Personally, I have studied (1-3 times a week for 5 years) with a MD

specializing in Orthopedic Medicine. When I was in school and in

China

(were lab work was routine in our TCM hospital) I made it a point to

try to understand all the information that was presented to me.

Therefore, I studied all lab work needed to diagnose a disease that

we

were covering at school.

>

> I believe my liability is less if I order studies and refer the

patient out if abnormalities are found, than if I miss a cancer or

alike.

>

> Alon

 

Aha, so you do have significant personal training and experience in

this area. Do you really think all of our collegues, some of whom

can

barely read, should also be doing this, too?

 

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, <alonmarcus@w...> wrote:

ordering lab tests without extensive biomedical training

> borders on malpractice in my opinion.

>

> >>>>Amen.

> Alon

 

 

It appears we actually agree more than we disagree on this one.

 

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Aha, so you do have significant personal training and experience in this area. Do you really think all of our collegues, some of whomcan barely read, should also be doing this, too?>>>well the big question is were we are going not were we have been. Most Lac that do not know anything would not know what to order and therefor probably will never order a test anyway. Second like I said some basic tests can be done as a screening and refereed out if positive. My point is that we need to press forward and demand good education. As with all other professions there will be growing pains and many old timers will be left behind .

Alon

 

-

 

Sunday, August 27, 2000 10:09 AM

Re: lab tests

, <alonmarcus@w...> wrote:Personally, I have studied (1-3 times a week for 5 years) with a MD specializing in Orthopedic Medicine. When I was in school and inChina (were lab work was routine in our TCM hospital) I made it a point to try to understand all the information that was presented to me. Therefore, I studied all lab work needed to diagnose a disease thatwe were covering at school. > > I believe my liability is less if I order studies and refer thepatient out if abnormalities are found, than if I miss a cancer oralike. > > Alon Aha, so you do have significant personal training and experience in this area. Do you really think all of our collegues, some of whomcan barely read, should also be doing this, too?ToddChinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

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It appears we actually agree more than we disagree on this one.>>>correct

Alon

 

-

 

Sunday, August 27, 2000 10:11 AM

Re: Lab Tests

, <alonmarcus@w...> wrote:ordering lab tests without extensive biomedical training > borders on malpractice in my opinion.> > >>>>Amen. > AlonIt appears we actually agree more than we disagree on this one.ToddChinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

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