Acupuncturists or Physicians?

July 16, 2003

Dear friends,

Please let me clarify where I am coming from: As others have said, I am

so frustrated with the mediocrity of the basic TCM MS curriculum. But I

also understand why: the bottom line is preparing students to pass the

California state Board exam (or the national board as the case may be).

In fact, my school did quite well, as last time around 81% of first time

takers passed.

But the larger question we must ask ourselves is: are those who are

licensed to practice acupuncture and TCM in California really qualified

to practice as Oriental medical physicians ? Our responsibility in

treating patients is enormous--at the very least affecting the quality of

their lives, and at times even saving their lives. If our manifest

destiny is to be more than just massage therapists with a gimick

(needles), if we really apply the principles of differential diagnosis

and our treatment is based upon creating balance, and prioritizing the

branch and root concerns, rather than just attacking local signs and

symptoms, then it is imperative that from on high, (meaning from you,

the leaders of our profession, and the principals of the regulating

organizations) intense effort be made to raise the lowest common

denominator, make it much more difficult to pass the state board, and

dramatically increase the clinical internship requirement, as with

medical interns. I realize that what I am saying is extremely unpopular,

but isn't the bottom line intellectual honesty and peer status with other

licensed physicians? (or is it? I know many fine acupuncturists that

are happy just placing needles to treat pain, or treat workers comp

patients, without doing intakes at all, and make lots of money to boot!)

It all trickles down: lack of emphasis on Medical chinese language

creates a dependancy on poorly translated texts or texts which reflect

the agenda of the translator. Ridiculously low Admission standards to

TCM schools where essentially all comers are welcomed, encourages a

mediocre level of scholarship. How come Western Med schools and

Osteopathic schools are so difficult to get in to and our schools are so

easy? Furthermore, how come the amount of clinical hours required is so

much less then the grueling internships MDs are required to go through?

What about the quality of our internship? My experience, and the

experience of many of my peers is that it is a joke...and you know why?

because we are not graded on the cases we treat. Why aren't we required

to review critically with our clinical supervisors all of our cases,and

write up case histories on a regular basis for analysis? Is there really

any motivation for the student intern to apply himself if he elects to

coast his way through clinic? absolutely not!

The DAOM degrees now being offered present a partial solution for those

who care to know more. But shouldn't everyone who practices acupuncture

and OM be as qualified to practice TCM as an MD is to practice

allopathic medicine? Here's an idea to consider: Why not consider the

Lac equivalent to the nurse practitioner in allopathic medicine, meaning,

a qualified healthcare provider, but not a physician, and the DAOM

equivalent to the MD?

Again, it probably would be extremely unpopular, but why not establish a

specific ceu curriulum to justify those who are already licensed, but

have taken far fewer hours of formal didactic study , to earn the DAOM

if they so desire. Then the two tiered approach could really mean

something, and really raise the standard of those who want to be

considered as Doctors.

Respectfully Yours,

Yehuda Frischman

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July 16, 2003

Yehuda,

I, for one, as a professor the last 13 years, understand and

appreciate your comments. I realize this is a complex topic, but do

understand that the development and growth of this profession is

evolutionary (after the initial 'revolution' of alternative medicine).

All of your concerns are valid, and your points well taken. However,

it will take quite a long time for professional development and

education to reach fruition because of the complexity of degree,

licensure, and the economics of limited resources for research and

development. The core of individuals of good heart and dedication, I

hope, will continue to develop the profession in a positive direction.

On Wednesday, July 16, 2003, at 01:52 AM, yehuda l frischman wrote:

> Dear friends,

>

> Please let me clarify where I am coming from: As others have said, I am

> so frustrated with the mediocrity of the basic TCM MS curriculum.

July 16, 2003

, yehuda l frischman

<@j...> wrote:

, then it is imperative that from on high, (meaning from you,

> the leaders of our profession, and the principals of the regulating

> organizations) intense effort be made to raise the lowest common

> denominator, make it much more difficult to pass the state board,

and

> dramatically increase the clinical internship requirement, as with

> medical interns.

Imagine other states such as here in colorado, where there is no

state exam, only a national exam. This allows schools the potential

to function even less efficiently. I thought the nationals were some

kind of sad joke. In all, i've found academic pressure in oriental

medicine school to be less then that of high school. Students

complain incessantly when things are challenging and many seem to

want to invest the bare minumum into their studies. Meanwhile my

school packs them in, accepting some 70 students into a class and

hiring teachers with sometimes only 2 years experience. What is

really frustrating is the fog of picking a school for yourself. Most

people getting into this stuff originally, know very little about it

and have little in terms of knowledge resources to discriminate

amongst schools. Maybe somebody will one day be brave enough one day

to write reviews of all these institutions.

I realize that what I am saying is extremely unpopular,

> but isn't the bottom line intellectual honesty and peer status with

other

> licensed physicians? (or is it? I know many fine acupuncturists

that

> are happy just placing needles to treat pain, or treat workers comp

> patients, without doing intakes at all, and make lots of money to

boot!)

>

> It all trickles down: lack of emphasis on Medical chinese

language

> creates a dependancy on poorly translated texts or texts which

reflect

> the agenda of the translator. Ridiculously low Admission standards

to

> TCM schools where essentially all comers are welcomed, encourages a

> mediocre level of scholarship.

If there were less schools, scholarship wouldn't be as hard to get

around. People shouldn't teach unless they never gave up the desire

to always be learning and they should be willing to learn

the " right " things.

How come Western Med schools and

> Osteopathic schools are so difficult to get in to and our schools

are so

> easy?

Lack of high standards or even consensus on what we should be the

deciding credentials.

Furthermore, how come the amount of clinical hours required is so

> much less then the grueling internships MDs are required to go

through?

> What about the quality of our internship? My experience, and the

> experience of many of my peers is that it is a joke...and you know

why?

> because we are not graded on the cases we treat. Why aren't we

required

> to review critically with our clinical supervisors all of our

cases,and

> write up case histories on a regular basis for analysis? Is there

really

> any motivation for the student intern to apply himself if he

elects to

> coast his way through clinic? absolutely not!

>

> The DAOM degrees now being offered present a partial solution for

those

> who care to know more. But shouldn't everyone who practices

acupuncture

> and OM be as qualified to practice TCM as an MD is to practice

> allopathic medicine?

Here's an idea to consider: Why not consider the

> Lac equivalent to the nurse practitioner in allopathic medicine,

meaning,

> a qualified healthcare provider, but not a physician, and the DAOM

> equivalent to the MD?

Because it wouldn't be fair to all of those wizened individuals who

would never want to just pick up and leave there practice so that

they can be a student again. Are they nurses? no..

>

> Again, it probably would be extremely unpopular, but why not

establish a

> specific ceu curriulum to justify those who are already licensed,

but

> have taken far fewer hours of formal didactic study , to earn the

DAOM

> if they so desire.

this makes so much sense to me. We obviously can't expect

practitioners to leave their practice in order to pursue a degree

with only real symbolic value. If people were able to to do CEU's

from reputable sources and combine that with an internship in China,

we'd have a D.A.O.m that makes sense to those people already

established in a community.

Then the two tiered approach could really mean

> something, and really raise the standard of those who want to be

> considered as Doctors.

>

> Respectfully Yours,

>

> Yehuda Frischman

>

> ______________

> The best thing to hit the internet in years - Juno SpeedBand!

> Surf the web up to FIVE TIMES FASTER!

> Only $14.95/ month - visit www.juno.com to sign up today!

July 16, 2003

One other thing I thought of, besides the title (which some might consider

important, and others might not!).

Would not the DAOM really mean something if we could get with it:

1. Western medical hospital privileges, and

2. the right to administer injectables:

a) either a procaine or saline solution into specific points, perhaps even

more significantly,

b) administering sterile decocted medicinal formulae as is done in China.

I would love to hear feedback on these ideas, and any other ideas which would

set the DOAM apart from the Lac.

Sincerely,

Yehuda

______________

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July 16, 2003

This is abominable. No more, no less.

On Wednesday, July 16, 2003, at 02:48 PM, facteau8 wrote:

> Meanwhile my

> school packs them in, accepting some 70 students into a class and

> hiring teachers with sometimes only 2 years experience.

July 16, 2003

Yehuda,

I think more in terms of:

1) development of CM hospitals and the availablity of 'inpatient'

facilities

2) deepening of the internal medicine knowledge necessary to deserve

the DAOM degree

3) study of the classical literature with modern applications of same

4) deepening lifestyle counceling skills such as diet and behaviorial

issues

5) better mastery of diagnostic skills,

and, last but not least, being able to read medical Chinese. Without

that skill, the ability to carry out research will be quite limited.

Western hospital privileges are more dependent on politics with the

powers-that-be, and injectable herbs are just a fringe benefit. Let's

get better mastery of what we've already got in the field.

On Wednesday, July 16, 2003, at 03:01 PM, wrote:

>

> One other thing I thought of, besides the title (which some might

> consider important, and others might not!).

>

> Would not the DAOM really mean something if we could get with it:

> 1. Western medical hospital privileges, and

> 2. the right to administer injectables:

> a) either a procaine or saline solution into specific points,

> perhaps even more significantly,

> b) administering sterile decocted medicinal formulae as is done

> in China.

>

> I would love to hear feedback on these ideas, and any other ideas

> which would set the DOAM apart from the Lac.

>

> Sincerely,

>

> Yehuda

>

> ______________

> The best thing to hit the internet in years - Juno SpeedBand!

> Surf the web up to FIVE TIMES FASTER!

> Only $14.95/ month - visit www.juno.com to sign up today!

>

July 16, 2003

I don't know where facteau8 is, but I hope this is not the norm. In the

school where I teach, 25 students is the max in a classroom, with occasional

exceptions in courses taught by the President, whose time is so limited. And

5 years' experience is the minimum, clincal experience that is, for

acupuncture and herb and TCM theory courses.

Julie

> This is abominable. No more, no less.

>

> > Meanwhile my

> > school packs them in, accepting some 70 students into a class and

> > hiring teachers with sometimes only 2 years experience.

July 16, 2003

Wonderful ideas, Z'ev, especially the idea of a CM hospital, of course

affiliated with a school. My major concern, however, is the AMA's zealous

territorial problems with considering us physicians and the problems they have

with our practices. That is exactly why I am suggesting an intermediate, and

yes, political step for us to legistlatively be considered skilled physicians on

par (though different in practice) with allopathic MDs.

About mastery of Medical Chinese, I again through the gauntlet to you, my

masters and teachers: Currently, medical chinese is only offered as an elective

course. WHy can't the colleges be lobbied to make at least one course required,

and perhaps offer a second, more advanced elective course. By the way is it the

same at PCOM?

Yehuda

PS. have an easy fast, Z'ev

______________

The best thing to hit the internet in years - Juno SpeedBand!

Surf the web up to FIVE TIMES FASTER!

Only $14.95/ month - visit www.juno.com to sign up today!

July 16, 2003

, Julie Chambers <info@j...>

wrote:

> I don't know where facteau8 is, but I hope this is not the norm. In

the

> school where I teach, 25 students is the max in a classroom,

We often have around 30 to 35 or so to a classroom. My own class is

around that size,as a whole class. The first year students accepted

in the fall of this year had about 35 to their class, with another 30

some odd added on in the spring semester to that class. They don't

squeeze them all into the same classroom, but the amount of students

accepted into a graduating class, has increased almost doublefold. I

live in boulder, C.O.

with occasional

> exceptions in courses taught by the President, whose time is so

limited. And

> 5 years' experience is the minimum, clincal experience that is, for

> acupuncture and herb and TCM theory courses.

>

> Julie

>

> > This is abominable. No more, no less.

> >

> > > Meanwhile my

> > > school packs them in, accepting some 70 students into a class

and

> > > hiring teachers with sometimes only 2 years experience.

July 16, 2003

, " facteau8 " <facteau8>

wrote:

> , Julie Chambers

<info@j...>

> wrote:

> > I don't know where facteau8 is, but I hope this is not the norm.

In

> the

> > school where I teach, 25 students is the max in a classroom,

>

> We often have around 30 to 35 or so to a classroom. My own class

is

> around that size,as a whole class. The first year students accepted

> in the fall of this year had about 35 to their class, with another

30

> some odd added on in the spring semester to that class. They don't

> squeeze them all into the same classroom, but the amount of

students

> accepted into a graduating class, has increased almost doublefold.

I

> live in boulder, C.O.

Just to clarify,

There are some very good teachers at my own school who have

taught me much. I think my last post was a bit hard around the

edges. My own issues mostly concern the sometimes seeming industry

of chinese medicine schools in the U.S. I think schools need more

small mentor type avenues in our initial education and less large

classrooms and old textbooks. Going through 3,000 or so hours of

education is a firm beginning in all this stuff and nothing more.

Students need more time(at least 4,000 hours), with all this and

definitely more intellectual orientation. If we aren't passionate

about this medicine then how will it ever amount to anything.

How do you inspire someone to love learning?

I always thought it was pretty amazing the way Bucky Fuller could

inspire the most different sorts of characters to take his talk to

heart and think about it. He'd be standing there... talking about

dodecahedrons, gravity and symmetry of it all, and so many people

thought about it deeply. he was so calm and joyous.

Chu Hsi says, in his " Learning to be a sage "

" A man reading is like a man drinking wine. A man who

loves drinking will finish one cup and want still another. A man who

doesn't love it will force his way through one cup and stop. "

" In reading, simply take what you already understand and read it

again and again "

Maybe the major requirement for entrance into schools should be the

serious desire to hit the books for the rest of one's life.

The inherent challenge and ethical responsibility of practicing

good chinese medicine is a very large one indeed. Our foundations and

inital perceptions of it are mostly founded in our educational walls.

This is another good reason why some sort of doctoral program should

replace the masters degree program and language should certainly be a

major part of the program. We are studying Chinese medicine, aren't

we? If a Chinese scholarly doctor is still learning, how much harder

our own path to knowledge.

matt

>

> with occasional

> > exceptions in courses taught by the President, whose time is so

> limited. And

> > 5 years' experience is the minimum, clincal experience that is,

for

> > acupuncture and herb and TCM theory courses.

> >

> > Julie

> >

> > > This is abominable. No more, no less.

> > >

> > > > Meanwhile my

> > > > school packs them in, accepting some 70 students into a class

> and

> > > > hiring teachers with sometimes only 2 years experience.

July 16, 2003

Matt,

>

> Maybe the major requirement for entrance into schools should be

the

> serious desire to hit the books for the rest of one's life.

> The inherent challenge and ethical responsibility of

practicing

> good chinese medicine is a very large one indeed. Our foundations

and

> inital perceptions of it are mostly founded in our educational

walls.

> This is another good reason why some sort of doctoral program

should

> replace the masters degree program and language should certainly be

a

> major part of the program. We are studying Chinese medicine, aren't

> we? If a Chinese scholarly doctor is still learning, how much

harder

> our own path to knowledge.

> matt

Well put. We can no longer afford

to consider the most basic aspects

of the subject...and therefore the

education and training in the subject

to be too much trouble or an extravagance

that only a few can afford.

Those in positions of authority and

leadership should pay attention to

what you are saying and demand that

students become literate and develop

the requisite skills to allow individuals

access to the sources of knowledge

that constitute the essence of the

subject.

Ken

July 17, 2003

Actually, I do not believe the degree will give you hospital privileges - but if a hospital hires you, you have hospital privileges.

Regarding injections, I believe that is because of politics, not a degree. In FL it is legal to use injection therapy.

So, I believe the degree is still a matter of academia, rather than really practicality.