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All,

 

I get the sense from the comments on this thread that people feel that

measuring practice trends only measures marketing or patient management

skills, not " real " clinical performance. To accept what you say I would need

to believe that clinical performance in Chinese medicine is so entirely

masked by other factors that it is impossible to measure how well we are

teaching clinical skills. I find that very hard to accept. If the survey

makes

sense and the population tested fits the questions, the trends will be useful.

What I have the most trouble believing, however, is that entry level

education is so fixed that change is beyond practical consideration. I cannot

believe either that there is nothing left to learn or that there is no will to

improve.

 

Bob

 

bob Paradigm Publications

www.paradigm-pubs.com 44 Linden Street

Robert L. Felt Brookline MA 02445

617-738-4664

 

 

---

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At 5:20 PM -0400 10/9/02, Robert L. Felt wrote:

>To accept what you say I would need

>to believe that clinical performance in Chinese medicine is so entirely

>masked by other factors that it is impossible to measure how well we are

>teaching clinical skills.

--

I don't doubt we'd get useful information from such a survey. Perhaps

I'mm missing your point, but what I don't see is that if we find that

x% of practitioners drop out after y years, how we could conclude

that the teaching of clinical skills is the issue to be addressed, as

opposed to any number of other factors.

 

 

>I find that very hard to accept. If the survey makes

>sense and the population tested fits the questions, the trends will

>be useful.

>What I have the most trouble believing, however, is that entry level

>education is so fixed that change is beyond practical consideration. I cannot

>believe either that there is nothing left to learn or that there is no will to

>improve.

--

Here we are in agreement. Do you have any thoughts about what changes

might be useful?

 

Rory

 

 

--

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, Rory Kerr <rorykerr@w...>

wrote:

I cannot

> >believe either that there is nothing left to learn or that there is

no will to

> >improve.

 

 

You know. I didn't say that, either. I said that entry level

education is not going to add medical chinese unless it

becomes a public safety issue. There is way too much

disagreement on this point to ever see this change made for

purely academic reasons. And it is not even a matter of waiting

for the old guard to retire, because the new guard is just as

ambivalent about this matter. I personally think Chinese should

be taught at the masters and have said so many times, even if it

means eliminating massage and qi gong classes.

 

In fact, there is quite a will to improve, but it only occurs within

certain boundaries. For example, with broad support from the

faculty, PCOM has moved into a case based learning model with

heavy emphasis on integrative medicine and the results have

been impressive so far. Not everyone liked this and other

changes and some have moved on, but the point is that we

agreed this was desirable and we made it happen. There is no

such consensus (obviously, if this list is an example) on the

issue of medical chinese at the master's level. In fact, the

consensus must be against this inclusion because almost no

school does it.

 

I think the style of education we are now applying at PCOM is

more focused on critical thinking so students can assess a

novel clinical event and know what resources to consult for

accurate info (like the PD and sionneau, for example). It is

developing this critical thinking skill that is the most important

responsibility of the schools, I think. Learning this skill within the

context of TCM allows the clinician to understand and utilize any

" data " they access. I don't think it's about learning more

" details " , but learning how to use those " details " effectively.

 

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, " Robert L. Felt " <bob@p...>

wrote:

> All,

>

> I get the sense from the comments on this thread that people

feel that

> measuring practice trends only measures marketing or patient

management

> skills, not " real " clinical performance.

 

It may indeed be an useful measure of clinical performance, but

I believe this would still tell us nothing about the role of

education. Because clinical success (in terms of patients

getting well, not just practitioners getting rich) is also largely

independent of one's education. The same practitioners I

mentioned who happen to have had meager educations, yet

great financial success are also excellent clinicians whose

patients are completely satisfied. So their clinical performance

is not in question, nor is it masked by the other factors. It just

appears to have nothing to do with their " education " , per se. My

point is that none of these factors tells us much about the role of

training in one's success But these are anecdotes, so ....

 

I am still interested in such a survey for several reasons. And I

would certainly be curious to see if those who trained more

recently (thus receiving a more rigorous education than when I

was in school) actually do better financially and clinically than

those trained earlier. I suspect the issue of deciding who is

more or lesser trained would be the hardest part of such a study.

And therein lies the rub. If the purpose of such a study is to

identify whether improving educational standards translates to

increased financial success, we have to first rank the

curriculums of all the acupuncture schools according to some

criteria. And compare these to all the prior curriculums over the

past 20 years or so. Account for CE and clinical experience and

self-study. and also, to be fair, consider the marketing plans of

each respondent. I mean if a person failed because they did no

marketing, it would erroneous to conclude their education in

TCM was lacking.

 

It certainly wouldn't hurt just to do an initial survey very basic. Net

income from working in the field (many practitioners will report

gross income, especially when attempting to sell their

practices), year of graduation, degree completed (if any),

accreditation of school. We could then consider the other very

important issues later, if necessary. Bob would be right if the

initial survey showed overwhelmingly that those with master's

degrees far outstripped those who went to 1800 hour programs

in the eighties. I would be real curious to see if this true. I

suspect the survey would yield less stark results than this and

the other issues I mentioned would become of paramount

importance in sorting out the matter.

 

Finally, a good survey would have to be statistically significant.

Since there is no way to get a large number of our colleagues to

comply with this, we have to determine what constituted a

respresentative sample of ages, prior education and careers,

etc. I do not believe the type of polling used at Acupunture

Today, for example, is of any relevance since the respndents are

self selected. A survey of the self-selected, which all prior

surveys of this type in our field were, I believe, would be worse

than useless because it would lead to erroneous conclusions

and possibly policy changes as a result.

 

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That is correct. I'll see you then. Or meet me at the hotel up the

street.

 

Z'ev

On Thursday, October 10, 2002, at 09:31 AM, wrote:

 

> , Rory Kerr <rorykerr@w...>

> wrote:

> I cannot

> > >believe either that there is nothing left to learn or that there is

> no will to

> > >improve.

>

>

> You know.  I didn't say that, either.  I said that entry level

> education is not going to add medical chinese unless it

> becomes a public safety issue.  There is way too much

> disagreement on this point to ever see this change made for

> purely academic reasons.  And it is not even a matter of waiting

> for the old guard to retire, because the new guard is just as

> ambivalent about this matter.  I personally think Chinese should

> be taught at the masters and have said so many times, even if it

> means eliminating massage and qi gong classes. 

>

> In fact, there is quite a will to improve, but it only occurs within

> certain boundaries.  For example, with broad support from the

> faculty, PCOM has moved into a case based learning model with

> heavy emphasis on integrative medicine and the results have

> been impressive so far.  Not everyone liked this and other

> changes and some have moved on, but the point is that we

> agreed this was desirable and we made it happen.  There is no

> such consensus (obviously, if this list is an example) on the

> issue of medical chinese at the master's level.  In fact, the

> consensus must be against this inclusion because almost no

> school does it. 

>

> I think the style of education we are now applying at PCOM is

> more focused on critical thinking so students can assess a

> novel clinical event and know what resources to consult for

> accurate info (like the PD and sionneau, for example).  It is

> developing this critical thinking skill that is the most important

> responsibility of the schools, I think.  Learning this skill within the

> context of TCM allows the clinician to understand and utilize any

> " data " they access.  I don't think it's about learning more

> " details " , but learning how to use those " details " effectively.

>

 

>

>

<image.tiff>

>

>

> 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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Sorry. . .went to the wrong address. This is for a meeting with an

acupuncture colleague in Denver.

 

Z'ev

On Thursday, October 10, 2002, at 11:25 AM, wrote:

 

> That is correct. I'll see you then. Or meet me at the hotel up the

> street.

>

> Z'ev

> On Thursday, October 10, 2002, at 09:31 AM, wrote:

>

>> , Rory Kerr <rorykerr@w...>

>> wrote:

>> I cannot

>> > >believe either that there is nothing left to learn or that there is

>> no will to

>> > >improve.

>>

>>

>> You know.  I didn't say that, either.  I said that entry level

>> education is not going to add medical chinese unless it

>> becomes a public safety issue.  There is way too much

>> disagreement on this point to ever see this change made for

>> purely academic reasons.  And it is not even a matter of waiting

>> for the old guard to retire, because the new guard is just as

>> ambivalent about this matter.  I personally think Chinese should

>> be taught at the masters and have said so many times, even if it

>> means eliminating massage and qi gong classes. 

>>

>> In fact, there is quite a will to improve, but it only occurs within

>> certain boundaries.  For example, with broad support from the

>> faculty, PCOM has moved into a case based learning model with

>> heavy emphasis on integrative medicine and the results have

>> been impressive so far.  Not everyone liked this and other

>> changes and some have moved on, but the point is that we

>> agreed this was desirable and we made it happen.  There is no

>> such consensus (obviously, if this list is an example) on the

>> issue of medical chinese at the master's level.  In fact, the

>> consensus must be against this inclusion because almost no

>> school does it. 

>>

>> I think the style of education we are now applying at PCOM is

>> more focused on critical thinking so students can assess a

>> novel clinical event and know what resources to consult for

>> accurate info (like the PD and sionneau, for example).  It is

>> developing this critical thinking skill that is the most important

>> responsibility of the schools, I think.  Learning this skill within

>> the

>> context of TCM allows the clinician to understand and utilize any

>> " data " they access.  I don't think it's about learning more

>> " details " , but learning how to use those " details " effectively.

>>

>

>>

>>

> <image.tiff>

>>

>>

>> 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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" The same practitioners I mentioned who happen to have had meager

educations, yet great financial success are also excellent clinicians

whose patients are completely satisfied. "

>

 

 

This is an excellent point. Therefore; what is success? I suggest

that a practice be viewed as " successful " primarily based on

treatment

results and secondarily on financial numbers. Is success based solely

on patient satisfaction? What about practitioner satisfaction in the

pursuit of excellence?

 

This is certainly a complicated issue worthy of further exploration.

 

Mark Fradkin

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Mark et al.,

 

Your point is a good one. I think that different surveys might be used

to determine different things. There could be one survey for patient

satisfaction, another survey for financial success, and a third survey

for practitioner satisfaction. Success is too broad a term connoting

different things to different persons unless the type of success is

specified. That being said, I do think a survey of net and gross

earnings, numbers of patients per week, type of practice setting, and

five and 10 year retention rates within the profession post graduation

would be useful in terms of overall professional development. It's

hard to know where you're going if you don't have a clear idea of

where you are.

 

Bob

 

, " fradkin724 " <mfrad@b...> wrote:

> " The same practitioners I mentioned who happen to have had meager

> educations, yet great financial success are also excellent

clinicians

> whose patients are completely satisfied. "

> >

>

>

> This is an excellent point. Therefore; what is success? I suggest

> that a practice be viewed as " successful " primarily based on

> treatment

> results and secondarily on financial numbers. Is success based

solely

> on patient satisfaction? What about practitioner satisfaction in

the

> pursuit of excellence?

>

> This is certainly a complicated issue worthy of further exploration.

>

> Mark Fradkin

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