Lab Tests

[Guest guest]

When I was trained in CA in the 80's, we had 4 full semester clases on lab

testing, and this type of asic training is what is esentially necesary to be

able to figure if something is necessary and to be able to make decisions to

refer out when the results are sent to us, as the lab tests are self

explanatory, and if not, are usually gone over by a speciaist before even

getting into our hands. As one DO I talked to about this said, " If it wasn't

for the $10 co-pay, docs wouldn't care if you got lab tests or not. The way

they are set up, most of the decision making is done by the nurse who opens

the letter anyway. " It is about money, generally speaking. This is not to say

that those who have had NO clases in lab tests should be going out and

ordering them, however. A certain level of understanding is necessary.

Probably as much training as the docs require to do acupuncture.

David Molony

In a message dated 8/25/00 2:10:43 PM, writes:

 

<< 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. >>

[Guest guest]

In a message dated 8/26/00 1:01:20 PM, alonmarcus writes:

 

<< 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. >>

 

And this should be the goal of learning the tests, to do better referrals and

to watch the effects of our medicines on the gross level that these tests

provide. This should be within the scope of practice of anyone using herbal

and supplemental medicine. If one chooses not to use it, that is fine, but to

be kept from using it is wrong, and this happens in most every state.

David Molony

 

DAVe

[Guest guest]

some of whomcan barely read, should also be doing this, too?>>>>>>

Unfortunately true. But, going foreword we need a new breed.

alon

 

-

acuman1

Tuesday, August 29, 2000 6:43 AM

Re: Re: lab tests

In a message dated 8/27/00 1:10:21 PM, writes:<< 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?Todd >>I thhink this is a wee bit unfair and elitist, Mr Todd. They generally choose to remain ignorant of subjects that don't particularly interest them. If convinced of the utility, the vast majority would follow through.DAVeChinese 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.

[Guest guest]

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

 

 

Alon and all,

 

I had a very similar experience while over in China, studying for 5 weeks,

last year. Meaning that the hospital I studied in was very integrative and

that it was very common for the ordering of lab tests in conjunction with

TCM. Then again, over there it is my understanding that the students study

for longer... like 7 years and are considered to be MD's. Personally, I

like the idea of being able to order lab tests! PCOM has it set up so that

we can order lab tests, if need be. I find them extremely easy to read

being that anything that is " out of range " , very clearly says so. I then

can read up on it and learn more. Of course, TCM is my primary concern,

however the more integrative I can be between the 2 worlds... then all the

more helpful, I can be for my patient. As a patient without insurance or

physician... I was really grateful that my acupuncturist could order some

blood tests... it certainly made my life much easier *S*, not to mention

saved me money!!!

 

I agree that as a whole we need to move forward... some practitioners...

for whatever reason will never order a lab test, I for one... want to be

able to, if need be!!!

 

I am really loving this list... and all the opinions people have about this

topic, and others!

 

Teresa Hall, Class of 2000

[Guest guest]

It is ironic to me that we are debating over increasing training of

biomedical tests, biomedical sciences, increasing requirements, etc. It

seems that all participants in this discussion are well versed in these

requirements. . . .after all, they are taught in universities and medical

schools across the country.

 

What the 10 million dollar question is, and NO ONE IS ASKING in this

discussion:

 

How do we upgrade and increase our Chinese medical training? Are we

assuming that we are well trained enough? I hear nothing here but lip

service about Chinese medicine, I hear " classics " in parentheses, showing a

clear bias against studying them.

 

I don't think there is one person in this particular discussion who is

conversant in the essential Chinese medical literature, and I would not want

to put the future of our profession in the hands of these individuals

without that ability. Without much more thorough training in Nei Jing, Nan

Jing, Shang Han Lun, and Yi Jing, we don't stand much chance of establishing

an independent profession, because without these classical texts, we cannot

understand the principles and ground upon which this medicine is built.

 

If you look at the posts on this and several other on-line

TCM/acupuncture/Chinese herbal medicine groups, it is clear that the ability

to diagnose via pulse, tongue and questioning is at a very facile stage.

There is almost no reference to the seminal texts, and little if any

knowledge of any material from them. Most practitioners are adrift,

floating in a sea of confusion. This does not bode very well for us. I,

myself struggle daily to master this great art, and pray for moments of

clarity in my work. My tools are the Shang Han Lun, Nan Jing, and Treatise

on the Spleen and Stomach. They provide me with much more understanding of

health and disease than anything else. They are the foundation on which I

take care of my patients every day.

 

And yet, I am inadequate for the task. My Chinese skills are still

relatively weak, and translation work is slow. We need more people to walk

the walk, not just a handful.

 

Chinese medicine stood on its own feet for 2000 years without any other

influence, and did a great job in caring for the Chinese people. If we

cannot study this medicine without prejudice, hybridization or a lifelong

dedication to the subject, we should not dictate to others what this

medicine is or should be. Again, as I have said in many posts, the

techniques may survive, but the heart of the medicine will not.

 

If you want to study biomedicine, fine. Go to medical school. The future,

Alon and others, is not just learning lab testing. We who are teachers of

Chinese medicine are trying to figure out, as David noted, what is the

necessary biomedical training for a practitioner of Chinese medicine, but

not at the expense of Chinese medicine itself. I would personally like

Western medical treatment to be handled by the professionals who are trained

in that system, and be the best Chinese medical practitioner I can possibly

be. I am willing to devote the rest of my life to that pursuit.

 

 

[Guest guest]

Thank you Zev for your insightful commentary. I have been in practice for 18

years and I too rely on classics-not as a ball and chain, but as my

foundation for clear bianzheng. scholarship of these classics is always

deepens me as a practitioner. Even with all my experience, I perpetually feel

like a beginner. At least once a year I think " I finally know what I'm

doing " - only to be thrown back into an abyss of confusion. How do I resolve

this? I study more! This is the difference between my students and myself: my

willingness and enthusiasm for study.

At moments when I feel bored w/ my practice-the answer always is to pay

closer attention.

Expanding into western blood tests can be a practical move-china has

integrated both medicines often to its best advantage-but not at the expense

of the classics. This does not mean that my practice isn't filled w/modern

innovations-it is. I keep up with and integrate as much as I can. We can have

practices that include and honor all these systems.

 

Cara Frank

[Guest guest]

Chinese medicine stood on its own feet for 2000 years without any otherinfluence, and did a great job in caring for the Chinese people

>>>>your are having lots of assumptions here.

 

 

We who are teachers ofChinese medicine are trying to figure out, as David noted, what is thenecessary biomedical training for a practitioner of Chinese medicine, butnot at the expense of Chinese medicine itself. I would personally likeWestern medical treatment to be handled by the professionals who are trainedin that system, and be the best Chinese medical practitioner I can possiblybe. I am willing to devote the rest of my life to that pursuit.

>>>I agree we need to substantially increase our OM training. However like in China I strongly believe we need to understand biomedicine or we will continue to make assumption with little ability to evaluating them. There is a reason they requite biomedical training in the PRC. An independent profession implies a non-supervised practice. When I was in China in 1985 I had long conversations just about this subject with a very well known physician (a western train in charge of evaluating outcomes and safety of TCM only trained doctors. He was well trained in TCM as well) and he told me that without biomedicine training the deaths resulting by inability to diagnose life threatening diseases was huge, and that is the reason biomedical training is necessary. We here in the US see a minute % of the population and usually as treachery care. However, once patients see how much we can help they often use us as their primary care providers, at least here in CA. Not having at least a year of real clinical training in biomedicine is a crime, extremely irresponsible and dangerous. For example, I see newly licensed practitioners in my office evaluating patients for nausea, st pain or burning, tingling in the face etc w/o having any idea that these can be signs of angina. As a meter of fact I had such a patient 3 years ago. He came for nausea and tooth pain and the newly licensed LAc was taking his history and had no idea to even ask if the symptoms come-on excretion. This patient was having a heart attack in the office.

We either have the appropriate education or we should not have the right to see undiagnosed patients. Having been trained does not mean mistakes will not occur, as we can see every day with MD debacles, but they will occur less frequently. We as a primarily OM professionals have more responsibilities then MDs or other biomedical trained professionals. We are practicing in a western culture and when we will start seeing millions of patients as their primary care providers we need to hold up both from a TCM clinical perspective as well as integrate w/ the medical cloture. We will need to defend our self's in mal practice suits ext.

In a 4000-4500 hr training we need at least 1000 of CLINICAL biomed training. And here we are w/ the schools resisting even a 3500 hr training.

alon

 

-

 

Tuesday, August 29, 2000 11:06 PM

Re: lab tests

 

It is ironic to me that we are debating over increasing training ofbiomedical tests, biomedical sciences, increasing requirements, etc. Itseems that all participants in this discussion are well versed in theserequirements. . . .after all, they are taught in universities and medicalschools across the country.What the 10 million dollar question is, and NO ONE IS ASKING in thisdiscussion:How do we upgrade and increase our Chinese medical training? Are weassuming that we are well trained enough? I hear nothing here but lipservice about Chinese medicine, I hear "classics" in parentheses, showing aclear bias against studying them.I don't think there is one person in this particular discussion who isconversant in the essential Chinese medical literature, and I would not wantto put the future of our profession in the hands of these individualswithout that ability. Without much more thorough training in Nei Jing, NanJing, Shang Han Lun, and Yi Jing, we don't stand much chance of establishingan independent profession, because without these classical texts, we cannotunderstand the principles and ground upon which this medicine is built.If you look at the posts on this and several other on-lineTCM/acupuncture/Chinese herbal medicine groups, it is clear that the abilityto diagnose via pulse, tongue and questioning is at a very facile stage.There is almost no reference to the seminal texts, and little if anyknowledge of any material from them. Most practitioners are adrift,floating in a sea of confusion. This does not bode very well for us. I,myself struggle daily to master this great art, and pray for moments ofclarity in my work. My tools are the Shang Han Lun, Nan Jing, and Treatiseon the Spleen and Stomach. They provide me with much more understanding ofhealth and disease than anything else. They are the foundation on which Itake care of my patients every day.And yet, I am inadequate for the task. My Chinese skills are stillrelatively weak, and translation work is slow. We need more people to walkthe walk, not just a handful.Chinese medicine stood on its own feet for 2000 years without any otherinfluence, and did a great job in caring for the Chinese people. If wecannot study this medicine without prejudice, hybridization or a lifelongdedication to the subject, we should not dictate to others what thismedicine is or should be. Again, as I have said in many posts, thetechniques may survive, but the heart of the medicine will not.If you want to study biomedicine, fine. Go to medical school. The future,Alon and others, is not just learning lab testing. We who are teachers ofChinese medicine are trying to figure out, as David noted, what is thenecessary biomedical training for a practitioner of Chinese medicine, butnot at the expense of Chinese medicine itself. I would personally likeWestern medical treatment to be handled by the professionals who are trainedin that system, and be the best Chinese medical practitioner I can possiblybe. I am willing to devote the rest of my life to that pursuit.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.

[Guest guest]

on 8/30/00 10:28 AM, alonmarcus at alonmarcus wrote:

 

 

My Groups </mygroups> | Main Page <> | Start a new group! <http://click./1/8150/11/_/542111/_/967657125/>

 

Chinese medicine stood on its own feet for 2000 years without any other

influence, and did a great job in caring for the Chinese people

>>>>your are having lots of assumptions here.

 

The thriving population of great size is indicative of great value in Chinese medicine.

 

 

We who are teachers of

Chinese medicine are trying to figure out, as David noted, what is the

necessary biomedical training for a practitioner of Chinese medicine, but

not at the expense of Chinese medicine itself. I would personally like

Western medical treatment to be handled by the professionals who are trained

in that system, and be the best Chinese medical practitioner I can possibly

be. I am willing to devote the rest of my life to that pursuit.

>>>I agree we need to substantially increase our OM training. However like in China I strongly believe we need to understand biomedicine or we will continue to make assumption with little ability to evaluating them. There is a reason they requite biomedical training in the PRC. An independent profession implies a non-supervised practice. When I was in China in 1985 I had long conversations just about this subject with a very well known physician (a western train in charge of evaluating outcomes and safety of TCM only trained doctors. He was well trained in TCM as well) and he told me that without biomedicine training the deaths resulting by inability to diagnose life threatening diseases was huge, and that is the reason biomedical training is necessary. We here in the US see a minute % of the population and usually as treachery care. However, once patients see how much we can help they often use us as their primary care providers, at least here in CA. Not having at least a year of real clinical training in biomedicine is a crime, extremely irresponsible and dangerous. For example, I see newly licensed practitioners in my office evaluating patients for nausea, st pain or burning, tingling in the face etc w/o having any idea that these can be signs of angina. As a meter of fact I had such a patient 3 years ago. He came for nausea and tooth pain and the newly licensed LAc was taking his history and had no idea to even ask if the symptoms come-on excretion. This patient was having a heart attack in the office.

We either have the appropriate education or we should not have the right to see undiagnosed patients. Having been trained does not mean mistakes will not occur, as we can see every day with MD debacles, but they will occur less frequently. We as a primarily OM professionals have more responsibilities then MDs or other biomedical trained professionals. We are practicing in a western culture and when we will start seeing millions of patients as their primary care providers we need to hold up both from a TCM clinical perspective as well as integrate w/ the medical cloture. We will need to defend our self's in mal practice suits ext.

In a 4000-4500 hr training we need at least 1000 of CLINICAL biomed training. And here we are w/ the schools resisting even a 3500 hr training.

alon

 

Alon,

I am certainly not against biomedical training, or increasing it. . . .as long as it is RELEVANT to Chinese medical practitioners. As far as the schools resisting increasing training hours, there is a good reason for it. . .. the appearance of Doctor of Oriental Medicine programs in the next two years. If the masters level courses are increased, it will make it less likely that a doctorate will be feasable, for a number of reasons.

As far as endangered patients goes. . . .this speaks for internship. I feel that new practitioners should work under supervision of a senior licensed practitioner for at least one year. As well as basic biomedical 'red flags', Chinese medicine has a number of ways, through its very sophisticated diagnostics, of telling when a patient is endangered. I have personally been able to pick up ovarian cysts, heart ailments, and other disorders through the pulse, and then refer accordingly (as well as providing CM care). I realize this is difficult to do, but we must learn to do it.

 

The physicians you worked with in China sound admirable in their clinical skill, but I wonder how much they trust or rely on pulse diagnosis. Remember that Chinese medicine is not in its glory days in mainland China, and that many skills may have been diluted or fallen out of use. From where I sit, it looks like there is a clear bias to biomedicine in China, especially in the hospital system.

 

By the way, I saw your book in a store here in Santa Fe (on vacation). It looks excellant. I'll check it out.

 

 

[Guest guest]

.. As well as basic biomedical 'red flags', Chinese medicine has a number of ways, through its very sophisticated diagnostics, of telling when a patient is endangered. I have personally been able to pick up ovarian cysts, heart ailments, and other disorders through the pulse, and then refer accordingly (as well as providing CM care). I realize this is difficult to do, but we must learn to do it. >>>>By all means. Let me know what you think of my book

alon

 

-

 

Wednesday, August 30, 2000 5:19 PM

Re: lab tests

 

on 8/30/00 10:28 AM, alonmarcus at alonmarcus wrote:

My Groups </mygroups> | Main Page <> | Start a new group! <http://click./1/8150/11/_/542111/_/967657125/> Chinese medicine stood on its own feet for 2000 years without any otherinfluence, and did a great job in caring for the Chinese people>>>>your are having lots of assumptions here. The thriving population of great size is indicative of great value in Chinese medicine.We who are teachers ofChinese medicine are trying to figure out, as David noted, what is thenecessary biomedical training for a practitioner of Chinese medicine, butnot at the expense of Chinese medicine itself. I would personally likeWestern medical treatment to be handled by the professionals who are trainedin that system, and be the best Chinese medical practitioner I can possiblybe. I am willing to devote the rest of my life to that pursuit.>>>I agree we need to substantially increase our OM training. However like in China I strongly believe we need to understand biomedicine or we will continue to make assumption with little ability to evaluating them. There is a reason they requite biomedical training in the PRC. An independent profession implies a non-supervised practice. When I was in China in 1985 I had long conversations just about this subject with a very well known physician (a western train in charge of evaluating outcomes and safety of TCM only trained doctors. He was well trained in TCM as well) and he told me that without biomedicine training the deaths resulting by inability to diagnose life threatening diseases was huge, and that is the reason biomedical training is necessary. We here in the US see a minute % of the population and usually as treachery care. However, once patients see how much we can help they often use us as their primary care provi! ders, at least here in CA. Not having at least a year of real clinical training in biomedicine is a crime, extremely irresponsible and dangerous. For example, I see newly licensed practitioners in my office evaluating patients for nausea, st pain or burning, tingling in the face etc w/o having any idea that these can be signs of angina. As a meter of fact I had such a patient 3 years ago. He came for nausea and tooth pain and the newly licensed LAc was taking his history and had no idea to even ask if the symptoms come-on excretion. This patient was having a heart attack in the office. We either have the appropriate education or we should not have the right to see undiagnosed patients. Having been trained does not mean mistakes will not occur, as we can see every day with MD debacles, but they will occur less frequently. We as a primarily OM professionals have more responsibilities then MDs or other biomedical trained professionals. We are practicing in a western culture and when we will start seeing millions of patients as their primary care providers we need to hold up both from a TCM clinical perspective as well as integrate w/ the medical cloture. We will need to defend our self's in mal practice suits ext. In a 4000-4500 hr training we need at least 1000 of CLINICAL biomed training. And here we are w/ the schools resisting even a 3500 hr training.alonAlon, I am certainly not against biomedical training, or increasing it. . . .as long as it is RELEVANT to Chinese medical practitioners. As far as the schools resisting increasing training hours, there is a good reason for it. . .. the appearance of Doctor of Oriental Medicine programs in the next two years. If the masters level courses are increased, it will make it less likely that a doctorate will be feasable, for a number of reasons. As far as endangered patients goes. . . .this speaks for internship. I feel that new practitioners should work under supervision of a senior licensed practitioner for at least one year. As well as basic biomedical 'red flags', Chinese medicine has a number of ways, through its very sophisticated diagnostics, of telling when a patient is endangered. I have personally been able to pick up ovarian cysts, heart ailments, and other disorders through the pulse, and then refer accordingly (as well as providing CM care). I realize this is difficult to do, but we must learn to do it. The physicians you worked with in China sound admirable in their clinical skill, but I wonder how much they trust or rely on pulse diagnosis. Remember that Chinese medicine is not in its glory days in mainland China, and that many skills may have been diluted or fallen out of use. From where I sit, it looks like there is a clear bias to biomedicine in China, especially in the hospital system. By the way, I saw your book in a store here in Santa Fe (on vacation). It looks excellant. I'll check it out.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.