source of income

[Guest guest]

I was thinking about vested interests and disclosure in terms of public

debate and it occurred to me that many o us on this list have different

sources of income, which may bias our positions. I generate most of my

income form teaching, either at PCOM, online or by organizing CEU events.

I currently generate no income at all from the private practice of

medicine, though I do personally see about 10 patients per week on salary

and supervise the treatment of another 50 or so. I believe most people on

this list generate the bulk of their income from private practice (with

other notable exceptions like Ken Rose, Bob Flaws, Bob Felt, plus those

who work for herb companies or do research, etc.). It would seem that

political changes that benefit the schools in terms of increased numbers

of students and higher salaries would influence myself and other educators,

while changes that resulted in increased professional status and less

economic competition would be of more interest to practitioners. However

if these goals are competing with each other, than one will surely have to

choose. For instance, if supporting an entry level DAOM results in many

schools closing, where does a teacher side? I like to think my actual

motivation is what's best for students and the public and the profession

in the long run. I assume others feel the same way about their own

positions. I only ask that people consider what interests they might have

that could bias their judgment.

 

 

Chinese Herbs

 

 

" Great spirits have always found violent opposition from mediocre

minds " -- Albert Einstein

[Guest guest]

 

 

Good question.

 

Personally, I make so little money from

my activity in the field that it doesn't

really influence any position that I take

on anything. My per hour rate of compensation

for the time I spend researching, writing,

teaching, lecturing...not to mention posting

on CHA...works out to so small a figure

as to be virtually incalculable.

 

This is not entirely a matter of choice,

as of course I would be glad of brisker

book sales. And perhaps this lies behind

my relentless assault on illiteracy in

the field.

 

I imagine that I might personally benefit

from a profession full of individuals

who were competent at reading and understanding

Chinese medical language and literature.

 

But I have no basis for this imagining.

 

Just wishful thinking.

 

Which seems to be enough to sustain my

interest.

 

Ken

[Guest guest]

Since I wear both hats (professor and private practitioner), I am

always in a unique position in the dichotomy of schools and private

practitioners. While I have income from both areas, I try to speak

what I mean and what I feel. . . .but always being sensitive to the

concerns of others in the profession and the colleges.

 

The waters are murky, and it is difficult to see clearly where the

profession and the colleges are going. I personally mistrust many of

the practitioners' organizations on many things, both at the state and

local level, although I try to work to support reasonable causes. The

various councils of schools and colleges also are troubled waters, in

my view, and, again, I am willing to support what I think are

reasonable causes from these institutions as well.

 

What I will not support is the ongoing 'war' between the practitioner

organizations and those representing the colleges. I think it has been

a blight on our profession.

 

As Ken and others have pointed out all along, I think we need to get

our priorities straight as a profession, and as long as there is

resistance to well-integrated medical Chinese study, and more in-depth

study in Chinese medical diagnosis and pattern differentiation, I am

not going to be convinced that we know in what direction we are going.

We will be patching up a faulty structure when we need to build a new

one on more solid ground. While I say this, I also recognize that at

the political level, change is slow and compromise is the order of the

day. But I do think a major rethink in direction is called for at this

point.

 

We should have true forums at the national state and local level to

discuss the direction of the profession and deal with the relevant

issues.

 

Sometimes you need to develop a new operating system rather than

continually patching up old code.

 

 

On Tuesday, July 22, 2003, at 09:49 AM, wrote:

 

> I was thinking about vested interests and disclosure in terms of

> public debate and it occurred to me that many o us on this list have

> different sources of income, which may bias our positions. For

> instance, if supporting an entry level DAOM results in many schools

> closing, where does a teacher side? I like to think my actual

> motivation is what's best for students and the public and the

> profession in the long run. I assume others feel the same way about

> their own positions. I only ask that people consider what interests

> they might have that could bias their judgment.

>

[Guest guest]

Z'ev,

 

I do think a major rethink in direction is called for at this

> point.

>

> We should have true forums at the national state and local level

to

> discuss the direction of the profession and deal with the relevant

> issues.

>

> Sometimes you need to develop a new operating system rather than

> continually patching up old code.

>

>

 

Your comments bring to mind some old

slogans from days gone by.

 

If not now, when?

If not us, who?

 

You're either part of the problem

or part of the solution.

 

Remember that being radical means

cleaving to the roots of things.

And that is precisely what this

field needs:

 

a return to its roots and a veneration

of its roots.

 

Currently, the roots are obscured

by a number of factors, some of which

we have discussed at length, and others

which remain to be revealed.

 

Ken

[Guest guest]

In a message dated 7/22/2003 5:09:40 PM Pacific Daylight Time, zrosenbe writes:

 

 

I personally mistrust many of the practitioners' organizations on many things, both at the state and local level, although I try to work to support reasonable causes. The various councils of schools and colleges also are troubled waters, in my view, and, again, I am willing to support what I think are reasonable causes from these institutions as well.

 

 

Z'ev

 

Can you cite some specific scenarios as the basis for concern?

 

best regards,

 

Will

[Guest guest]

> As Ken and others have pointed out all along, I think we need to get

> our priorities straight as a profession, and as long as there is

> resistance to well-integrated medical Chinese study, and more

in-depth

> study in Chinese medical diagnosis and pattern differentiation, I am

> not going to be convinced that we know in what direction we are

going.

> We will be patching up a faulty structure when we need to build a

new

> one on more solid ground. While I say this, I also recognize that

at

> the political level, change is slow and compromise is the order of

the

> day. But I do think a major rethink in direction is called for at

this

> point.

>

> We should have true forums at the national state and local level to

> discuss the direction of the profession and deal with the relevant

> issues.

>

> Sometimes you need to develop a new operating system rather than

> continually patching up old code.

>

>

 

I'm not at all sure visioning forums accomplish anything at all. In

my experience, top down change rarely accomplishes anything lasting

when dealing with large groups of people. Real change is driven by

perceived need. I don't think that the rank and file perceive a need

to radically change the profession. While a minority of (the better)

students may be unhappy with the education they receive, given the

nature of the people who go to acupuncture school in the first place,

I think a lot of people get exactly what they want/can hear/can do. I

also think the public pretty much gets what they want from their

acupuncturists. As long as one has acupuncture to " fall back on, "

upgrading of CM skills does not appear to me to be all that necessary.

(As I've said before, I don't think CM theory is necessary to do

effective acupuncture.) I think people (practitioners and their

patients) are succeeding enough with the way things are so that most

are willing (if not totally happy) to go along with the status quo.

While people want small upgrades, I don't think people want/need a

radical change in the way things are.

 

I guess this analysis is sort of a " Marxist " economic one (i.e.,

history is driven by economics), but that's my take in any case.

 

Bob

[Guest guest]

, " Bob Flaws " <

pemachophel2001> wrote:

 

I don't think that the rank and file perceive a need

> to radically change the profession.

 

that has been my point all along. no imposed change will have lasting results

if it is not perceived as having inherent value. Right now , it is believed that

upgraded entry level standards will solve our problems across the board. But

I do believe most schools will go out of business if this occurs. Which raises

the issue of the value of the school to our field. In WM, schools are a vital

driving force. They have huge resources and cash flow. They do most of the

research that determines the viability of the field. If we cripple the schools

with a proposal that will not result in any better patient outcomes and

increased costs for all parties, the entire field will suffer.

 

I really feel the whole drive towards entry level DAOM is very shortsighted,

mainly economically motivated and without vision. It serves the needs of one

vested interest - practitioners - at the expense of all others. While I do

believe that doctors need 6 years of education with extensive residency, I also

believe there are lower tiers of practice that are still effective for most

complaints. They say a PA can treat 85% of what walks in his door. That is an

example of a lower tier of western medical primary care. LNP is another.

 

I have a novel idea. Before we implement any costly and possibly catastrophic

educational changes in this top down fashion, why don't we actually study the

matter. The main interest of government regulators is safety and possibly

efficacy too, in some cases. If those with more extensive education can be

shown to score higher on valid assessments of safety and efficacy, then one

would be able to make an airtight case. Such an assessment would actually

have to involve the tracking of real patients treated by real doctors grouped

by educational status. I predict one thing we would find is that acupuncture

yields similar health benfits in the hands of those doing very sophisticated

styles and those doing cookbook formulas from Dr. So's manual (great stuff,

BTW).

 

And while herbs are not as forgiving, a half century of japanese and chinese

research do lend wide support to the idea that even allopathic prescribing of

herbs can have very positive effects. I also think there are those 15% of

complaints that are knotty and will not yield well to cookbook approaches. But

the clinical evidence as I see it is that there is a safe and effective place

for

many levels of practice, from inexpensive " therapists " to full fledged doctors

board certified in particular specialties. Doctors and scholars can always

frown

on therapists. But I say if they provide good care at low prices, then there

really is no case against them from a public health perspective. and consider

the fact that if going to a TCM herbalist becomes so outrageously expensive

due to cost of education, then we might actually drive more patients into the

healthfood stores for free advice. Studying this matter would really end the

debate and in fact is the only thing that would end the debate. Once we all

look through the telescope, we'll have to reconcile what we see. I am willing

to

put myself behind whatever position the actual evidence supports.

 

[Guest guest]

While I do

> believe that doctors need 6 years of education with extensive

residency, I also

> believe there are lower tiers of practice that are still effective

for most

> complaints. They say a PA can treat 85% of what walks in his door.

That is an

> example of a lower tier of western medical primary care.

 

I " fired " my MD and " hired " a PA. I get much, much better care from my

PA than I was getting from my MD. Not only does he listen better, he

actually knows more.

 

> I have a novel idea. Before we implement any costly and possibly

catastrophic

> educational changes in this top down fashion, why don't we actually

study the

> matter. The main interest of government regulators is safety and

possibly

> efficacy too, in some cases. If those with more extensive

education can be

> shown to score higher on valid assessments of safety and efficacy,

then one

> would be able to make an airtight case. Such an assessment would

actually

> have to involve the tracking of real patients treated by real

doctors grouped

> by educational status.

 

You've got my vote.

 

I predict one thing we would find is that

acupuncture

> yields similar health benfits in the hands of those doing very

sophisticated

> styles and those doing cookbook formulas from Dr. So's manual (great

stuff,

> BTW).

 

That's certainly my experience.

 

> And while herbs are not as forgiving, a half century of japanese and

chinese

> research do lend wide support to the idea that even allopathic

prescribing of

> herbs can have very positive effects. I also think there are those

15% of

> complaints that are knotty and will not yield well to cookbook

approaches. But

> the clinical evidence as I see it is that there is a safe and

effective place for

> many levels of practice, from inexpensive " therapists " to full

fledged doctors

> board certified in particular specialties. Doctors and scholars can

always frown

> on therapists. But I say if they provide good care at low prices,

then there

> really is no case against them from a public health perspective.

and consider

> the fact that if going to a TCM herbalist becomes so outrageously

expensive

> due to cost of education, then we might actually drive more patients

into the

> healthfood stores for free advice. Studying this matter would really

end the

> debate and in fact is the only thing that would end the debate.

Once we all

> look through the telescope, we'll have to reconcile what we see. I

am willing to

> put myself behind whatever position the actual evidence supports.

 

Good idea.

 

Bob

[Guest guest]

Cirriculum development

 

Licensure issues

 

Scope of practice

 

the Doctorate

 

 

On Wednesday, July 23, 2003, at 01:06 AM, WMorris116 wrote:

 

> In a message dated 7/22/2003 5:09:40 PM Pacific Daylight Time,

> zrosenbe writes:

>

>

> I personally mistrust many of

> the practitioners' organizations on many things, both at the state and

> local level, although I try to work to support reasonable causes.  The

> various councils of schools and colleges also are troubled waters, in

> my view, and, again, I am willing to support what I think are

> reasonable causes from these institutions as well.

>

>

>

> Z'ev

>

> Can you cite some specific scenarios as the basis for concern?

>

> best regards,

>

> Will

>

<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.

>

>

>

>

[Guest guest]

While I agree with you that the forum idea is not practically going to

happen, and I generally like to 'go with the flow' as far as changes in

the profession goes, I also think that our generation of practitioners

need to have some sense of visioning the future of where we'd like

things to go. It may take years, but hopefully in the future some

individuals will find inspiration in our thoughts and words, as well as

correcting whatever mistakes we have made along the way. I don't want

anything to happen that would put the schools under, or endanger our

profession. It is more an issue for me as to overall direction, and

what we need to do to continue to grow.

 

There are qualitative and quantitative modes of understanding

phenomena. While acupuncture can certainly be practiced according to a

wide variety of criteria, including western ones (Nogier

auricoltherapy, Voll electroacupuncture), I think there is a variance

in quality that leads to effective or ineffective treatment. From my

clinical perspective of over twenty years of full-time practice, I must

say I get many patients who didn't get results from one practitioner

who respond almost immediately to my treatment (or those equally or

more skilled). I get feedback on technique, on how the treatment

feels, so it is not just my 'vibes' or a specific placebo effect. The

closer I hew to more classical acupuncture theory and technique, the

better my results. Several of my colleagues report the same thing.

 

There is also no doubt that Chinese internal medicine is more rigorous,

and there is less room for mistake with more possible consequences.

However, even herbal medicine is practiced from a number of

perspectives, thus the different schools of thought on focusing on

spleen/stomach, purgation, nourishing yin, or resolving blood stasis.

 

I am presently reading a little book (way too expensive) by Joanna

Grant " A Chinese Physician:Wang Ji and the 'Stone Mountain Medical Case

Histories " . The book is disappointing in the lack of direct quotations

or actual case reports, but does a good job of giving a Ming dynasty

cultural perspective on the practice of medicine. Wang Ji clearly

practiced from a Zhu Danxi and Li Dongyuan orientation, with marked use

of supplementing medicinals, despite the protestations of fellow

practitioners and even patients who had different points of view. Wang

Ji also was biased against acupuncture and moxabustion, even though he

wrote a text on the subject.

 

I agree that having some practitioners concentrate only on

herbal/internal medicine is desirable, so we have a clearer idea of how

successful herbal medicine is. Or, we can devote a percentage of

practice to herbal medicine exclusively (as I sometimes do over the

years). I don't, however, buy the perspective that acupuncture/moxa is

somehow inferior to herbal medicine, or second-rate in any sense of

stature. I think it is very important to modern westerners, and that

the more subtle developments in certain circles of Japan, Korea, and

China should continue to be studied and developed.

 

 

On Wednesday, July 23, 2003, at 08:06 AM, Bob Flaws wrote:

 

> I

> also think the public pretty much gets what they want from their

> acupuncturists. As long as one has acupuncture to " fall back on, "

> upgrading of CM skills does not appear to me to be all that necessary.

> (As I've said before, I don't think CM theory is necessary to do

> effective acupuncture.)

[Guest guest]

Z'ev,

 

, " "

<zrosenbe@s...> wrote:

> While I agree with you that the forum idea is not practically going

to

> happen, and I generally like to 'go with the flow' as far as changes

in

> the profession goes, I also think that our generation of

practitioners

> need to have some sense of visioning the future of where we'd like

> things to go.

 

Fine. But what you/they/we are doing may/probably will have zero

impact on that future.

 

While acupuncture can certainly be practiced according

to a

> wide variety of criteria, including western ones (Nogier

> auricoltherapy, Voll electroacupuncture), I think there is a

variance

> in quality that leads to effective or ineffective treatment.

 

Are you saying that an expert in Voll or Nogier with comparable years

experience as yourself is not going to get comparable results? If

that's what you're saying, I disagree. J.R. Worsley just died. So

I've read several eulogies recently. From all accounts, he was a

master clinician for his patient population. Also from some acounts,

his theory was not up to some peoples' ideas of a good level.

 

From

my

> clinical perspective of over twenty years of full-time practice, I

must

> say I get many patients who didn't get results from one practitioner

> who respond almost immediately to my treatment (or those equally or

> more skilled).

 

Your assessment and the assessment of others' skill is subjective and

is a factor in your acupuncture treatments. We have all seen patients

who got better or worse results from various practitioners. My

experience is that those differences have little to do directly with

style, knowledge, etc. but more to do with how the practitioner and

patient feels about the practitioner's style, knowledge, etc. You

believe your skill is valuable, but that does not tell us how

objectively valuable that skill really is. Your feeling about your

skill may actually be the operable factor, not the " skill " itself.

 

I get feedback on technique, on how the treatment

> feels, so it is not just my 'vibes' or a specific placebo effect.

 

This feedback is subjective on the part of the patient and part of a

multifactorial interrelationship. Factor out all extraneous variables

(if you can/could) and then we can say what differences there are from

needle technique, point location, point choice and combination, etc.

 

The

> closer I hew to more classical acupuncture theory and technique, the

> better my results. Several of my colleagues report the same thing.

 

I think anyone who has known you for a while would identify this as

one of your biases. Not necessarily a bad thing, but something that

definitely affects your and your patients' experience of your

acupuncture.

 

I don't, however, buy the perspective that acupuncture/moxa

is

> somehow inferior to herbal medicine, or second-rate in any sense of

> stature.

 

I never said nor did I imply that acupuncture is second-rate or

inferior. If someone else did, that's their problem. If you're

responding to my post, then you're reading something into it I didn't

put there. I've said it before and I'll say it again: acupuncture is

magic (in the sense that I don't believe we begin to understand how

and why it works). Acupuncture is hugely powerful, hugely effective. I

only said that I do not believe that CM theory is necessary to its

practice. And I mean each and every word in that last sentence,

especially the word " necessary. " In other words, you can do

acupuncture based on any of a number of Oriental theories (or Western

theories), but I don't believe that any of those theories have

anything much to do with the outcomes achieved with this therapy.

 

Bob

[Guest guest]

On Wednesday, July 23, 2003, at 01:15 PM, Bob Flaws wrote:

 

> Are you saying that an expert in Voll or Nogier with comparable years

> experience as yourself is not going to get comparable results? If

> that's what you're saying, I disagree.

 

No, I am saying just the opposite. They probably will get comparable

results, although their treatment goals may be different than mine.

 

> J.R. Worsley just died. So

> I've read several eulogies recently. From all accounts, he was a

> master clinician for his patient population. Also from some acounts,

> his theory was not up to some peoples' ideas of a good level.

 

As far as Professor Worsley, I think that the combination of what he

knew (within his self-limiting system), his charisma, and his focus on

emotional-psychological-'spiritual' aspects of humanity (often not

emphasized in other approaches) combined to make him a powerful

healer. I see him more like a Mother Teresa figure, than, say, a Dr.

Yoshio Manaka figure.

 

I never said nor did I imply that acupuncture is second-rate or

inferior. If someone else did, that's their problem. If you're

responding to my post, then you're reading something into it I didn't

put there.

 

I was referring to a perceived bias that is historical as well as

modern, not yours personally. Professor Unschuld communicated to me

recently that (in his opinion) during the Qing dynasty and Republican

era acupuncture was delegitimized as a 'heroic' form of treatment in

favor of more hands-on approaches, such as tui na.

 

 

[Guest guest]

, " "

> <zrosenbe@s...> wrote:

>

> The

> > closer I hew to more classical acupuncture theory and technique, the

> > better my results. Several of my colleagues report the same thing.

 

Which is really not that meaningful in that many of my colleagues have

reported the opposite. Most of my career has been spent in settings where I

can actually observe and assess the results of a wide variety of techniques -

school clinics. You cannot have this experience in private practice. In

addition,

I could really care less what style of acupuncture works best. So I feel

somewhat objective and detached in saying that while any given practitioner

may do better at one style or another, there is no difference in overall

longterm results when looking at entire groups. In other words, the japanese

acupuncturists may think they do a better job, but if you follow their charts,

their success rates are no better or worse than the TCM crowd or the

orthopedists or even the NAET folks.

 

Just because one gets better results with a certain style or methodology says

nothing about the style and everything about the practitioner. The fact that

different practitioners all claim their style is the best and has adherents and

patients to prove it tells me something. that all styles work. I think people

get better results with styles they resonate with because they resonate with

these styles. This is indeed the placebo effect in action. If you like and

believe what you do, you will do it focused and with all your heart. And thus

pulse balancers show equal intent and success as motor point needlers do.

Until a controlled study is done, all claims to this effect are opinion and

anecdote, including mine. However, I will add that the vast majority of

modern research showing the effectiveness of acupuncture is allopathic,

reductionist and physiological. So despite the lack of controlled studies, I

think

the existing evidence lends much more weight to my position than the other. I

will yield to the evidence if it contradicts my belief, but I will not just

follow

tradition.

 

[Guest guest]

This is indeed the placebo effect in action. If you like and believe what you do, you will do it focused and with all your heart. And thus pulse balancers show equal intent and success as motor point needlers do. Until a controlled study is done, all claims to this effect are opinion and anecdote, including mine.

>>>DiDO

alon

[Guest guest]

Bob Flaws in his previous post says I am known to have a 'classical

bias'. I agree and make no apologies about it. At the same time, this

does not mean I am not open to other perspectives, just because some of

them do not interest me. I practice what I think I do best in the

vast landscape of medicine. If I have an 'agenda', it is to help

insure that a classical perspective (seen through a modern Westerner's

eyes) survives. This is by no means guaranteed in the present

socio-economic-political climate.

 

I also have some experience in large clinics where I can observe a wide

variety of approaches in medicine, some which work, some which don't.

I haven't just been sitting in my private clinic the entire time these

last twenty-plus years. And while I think Japanese approaches by and

large are 'superior', in terms of focus, subtlety, and delivery, I've

seen cases where a more aggressive style works better. I think medical

practice has to be a combination of focus and flexibility. After all,

the Nei Jing used quite a bit of blood letting, minor surgery (draining

pus) and aggressive methods such as fire needling.

 

 

On Wednesday, July 23, 2003, at 02:52 PM, wrote:

 

> , " "

>> <zrosenbe@s...> wrote:

>>

>> The

>>> closer I hew to more classical acupuncture theory and technique, the

>>> better my results. Several of my colleagues report the same thing.

>

> Which is really not that meaningful in that many of my colleagues have

> reported the opposite. Most of my career has been spent in settings

> where I

> can actually observe and assess the results of a wide variety of

> techniques -

> school clinics. You cannot have this experience in private practice.

> In addition,

> I could really care less what style of acupuncture works best. So I

> feel

> somewhat objective and detached in saying that while any given

> practitioner

> may do better at one style or another, there is no difference in

> overall

> longterm results when looking at entire groups. In other words, the

> japanese

> acupuncturists may think they do a better job, but if you follow their

> charts,

> their success rates are no better or worse than the TCM crowd or the

> orthopedists or even the NAET folks.

 

I'd be curious how you measure the success rates of different styles of

acupuncture, specifically NAET.

>

> Just because one gets better results with a certain style or

> methodology says

> nothing about the style and everything about the practitioner. The

> fact that

> different practitioners all claim their style is the best and has

> adherents and

> patients to prove it tells me something. that all styles work. I

> think people

> get better results with styles they resonate with because they

> resonate with

> these styles. This is indeed the placebo effect in action. If you

> like and

> believe what you do, you will do it focused and with all your heart.

> And thus

> pulse balancers show equal intent and success as motor point needlers

> do.

 

For different things, I would think. One doesn't (or shouldn't) use

motor points for emotional/psychological disorders.

 

> Until a controlled study is done, all claims to this effect are

> opinion and

> anecdote, including mine. However, I will add that the vast majority

> of

> modern research showing the effectiveness of acupuncture is allopathic,

> reductionist and physiological. So despite the lack of controlled

> studies, I think

> the existing evidence lends much more weight to my position than the

> other. I

> will yield to the evidence if it contradicts my belief, but I will not

> just follow

> tradition.

 

I am a little uncomfortable with your continued use of the term

'anecdote'. Since anecdotal information is considered to be

'second-hand', it would throw away much of the accumulated experience

recorded in the Chinese medical literature, making for an unfair bias

in drawing one's conclusions. Add to that the biases implicit in most

modern studies of acupuncture (and many other clinical phenomena as

well), and I really don't see where most modern studies of acupuncture

are truly authoritative or replace the experience of previous

generations. There are too many questions about study design,

especially when 'double-blind' or sham acupuncture points are used.

Rather, these studies should be seen, in my opinion, as complimentary

to the traditional literature.

 

I am also not sure what your belief is, in terms of following

'tradition' or using more modern methods. Especially when you make a

case for NAET results here, after expressing your problems with it in

previous postings.

 

There may be several other approaches to treatment with the modality

of acupuncture, but at a certain point, they are no longer in the realm

of Chinese or Eastern medicine. This is where we must make some kind

of distinction.

 

Finally, I don't see where studies are necessarily less biased than

so-called anecdotal case histories. The recent debacle of the years of

the conclusions drawn from clinical trials on hormone replacement

therapy should be enough to dispel that myth. What myth? That it is

possible to eliminate human bias and perspectives from these studies.

The observer never disappears, or fails to influence clinical results

in any format.

 

 

[Guest guest]

, " " wrote:

that all styles work. I think people get better results with styles

they resonate with because they resonate with these styles.>>>

 

 

 

et al:

 

I think this can obviously be said not only of acupuncture but of

herbal formulation, too. Whether practitioners use classical

formulas straight or with variations, make formulas from scratch, or

give combinations of general formulas, patients seem to get better

anyway at the same rate.

 

I agree that it will be up to the next generation to do the testing

to really see what is effective and what may be the preferable

methodology in acupuncture and herbs.

 

 

Jim Ramholz

[Guest guest]

The recent debacle of the years of the conclusions drawn from clinical trials on hormone replacement therapy should be enough to dispel that myth.

 

>>>>Actually that is exactly the

opposite. All the previous studies on horse estrogens used in people, were semiancdotal, so-called case and population studies. It is only when a truly randomized and blind study was done that the question was answered. WM is full of bad science

Alon

[Guest guest]

Alon,

I find it hard to believe that all the original studies were

semi-anecdotal, and that all the recent studies were randomized

and blind. If this is the case, why the sudden switch in format?

 

 

 

, " ALON

MARCUS " <alonmarcus@w...> wrote:

> The recent debacle of the years of

> the conclusions drawn from clinical trials on hormone

replacement

> therapy should be enough to dispel that myth.

>

> >>>>Actually that is exactly the

> opposite. All the previous studies on horse estrogens used in

people, were semiancdotal, so-called case and population

studies. It is only when a truly randomized and blind study was

done that the question was answered. WM is full of bad science

> Alon

[Guest guest]

I find it hard to believe that all the original studies were semi-anecdotal, and that all the recent studies were randomized and blind. If this is the case, why the sudden switch in format?>>>>It took this long to do a true randomized study because just like in CM in WM belief systems often prevail for a long time. Women felt better and simple population studies showed all these benefits. Except that the benefits where only due to the fact that women that took these horse hormones also took better care of themselves. They did a lot of retrospective studies but no real time large randomized study until the famous one. Evidence is not very easy to come by. Randomized and blinded teddy designs are done for just these reasons

 

why the sudden switch in format?>>>>>Because many treatments in WM are now being studied for evidence.

Alon

[Guest guest]

In a message dated 7/23/2003 10:24:58 AM Pacific Daylight Time, zrosenbe writes:

 

 

 

Cirriculum development

 

Licensure issues

 

Scope of practice

 

the Doctorate

 

 

Z'ev - I too am a practitioner involved in academia. I don't quite understand your mistrust of professional organizations on these matters. And contrary to Mr. Flaws, I consider the Visioning Search Task Force an Essential communication mode for peaceful alternatives to active undermining of either schools or the profession. I believe we must hold for the high ground and the potential of our profession in this culture. Nonetheless, the Little Hoover Commission will weigh in on scope, education and entry level criteria from a detached perspective. They will make calls in that process that will define this field for the whole country.

Will

[Guest guest]

Alon, Z'ev, Bob Flaws, and others,

 

Evidence is not very easy to come by.

 

I think this remark more or less sums up

a critical point that should be strongly

emphasized in this discussion. One of the

great lessons I've learned from Paul Unschuld's

work is that we (meaning us human beings)

do what we do with respect to medical care

based largely on, for lack a better term,

the status quo. We do what we do because

that's what we do.

 

It's an expression of who we perceive ourselves

to be.

 

I remember some time back that Bob Felt posed

the question here as to who do we think we

are. And I suggest that we need to revisit

such questions from time to time.

 

Bob Flaws called it perceived need.

But an even more basic way of stating

the proposition is simply: Perception.

 

One of the truly fascinating things about

science is that it is the tendency of science

to disprove virtually everything. Think

back to what people believed on the basis

of science as little as 100 years ago or

even 50 years ago. No doubt science of

the future will continue to manifest this

evidently inevitable tendency.

 

If you can hold your breath long enough,

you'll discover that everything you know

is wrong.

 

And one of the truly fascinating things

about Chinese medicine is that it has

lasted so long in what is an albeit

chaotic state, which nonetheless includes

certain critical elements of theory

and practice that continue to demonstrate

their applicability in successive ages

and in far flung parts of the world.

 

So are we talking about the source of

income? Or are we talking about the

source of ideas?

 

Why are the schools set up the way they

are?

 

Why do the early texts omit comprehensive

presentations and discussions of the nomenclature?

 

How have the vested interested become vested?

 

And who are we?

 

Ken

[Guest guest]

Dear Ken,

 

 

I really enjoy your passion and soul searching about our profession. One

objection that I had to your most recent epistle when you say:

 

 

" If you can hold your breath long enough,

you'll discover that everything you know

is wrong. "

 

Shouldn't we, as TCM practitioners, rather than being frustrated by being proved

" wrong " -- implying that there is an absolute right, (that being incongruous

with human inperfection) instead work on acquiring information, objectively,

without an agenda, applying and harmonizing it wtih other information we have

previously acquired, and then using that new knowledge

to balance and heal, ourselves, our patients and our world, using a quantum

relativistic perspective?

 

Respectfully,

 

Yehuda

 

______________

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[Guest guest]

Yehuda,

>

>

> I really enjoy your passion and soul searching about our

profession. One objection that I had to your most recent epistle

when you say:

 

I enjoy people's objections, and so far

as passion and soul searching, well,

guilty as charged.

>

>

> " If you can hold your breath long enough,

> you'll discover that everything you know

> is wrong. "

>

> Shouldn't we, as TCM practitioners, rather than being frustrated

by being proved " wrong " -- implying that there is an absolute right,

(that being incongruous with human inperfection) instead work on

acquiring information, objectively, without an agenda, applying and

harmonizing it wtih other information we have previously acquired,

and then using that new knowledge

> to balance and heal, ourselves, our patients and our world, using

a quantum relativistic perspective?

 

Well, I'm not entirely sure what a quantum

relativistic perspective is, but sure, why

not. All I meant was to agree with what

Alon had said about evidence being hard

to come by. I just opened up the field of

view on that idea and noticed that evidence

is really all relative to the making of

various arguments, claims, etc.; and when

you come right down to it we have to deal

with patients and not ideas...although

our patients, of course, are chock full

of ideas...not to mention our humble selves.

 

I'm gonna mull over what a quantum relativistic

perspective might be, but since Einstein could

never quite get the hang of it, I seriously

doubt that I'll be able to.

 

What seems to be implied, however, is some

novel frame of reference which, if attained,

would no doubt tend to demonstrate the

errors of earlier modes of perception

that had been " proven " by science.

 

I'm not sure we're disagreeing...

 

....but then again, we might be.

 

Ken

[Guest guest]

Let me clarify: What I mean is that because everything is constantly changing

in our world, and everything is affected by every other micro-event that occurs

in our universe, it is epistologically impossible for us to ever be completely

right or wrong or to ever " know " anything definitively. I feel that to claim

absolute knowledge is an expression of arrogance.

 

That being said, the gifts of intellect and analysis truly make our species

special and so I feel that to utilize those gifts to acquire information, and

refine our analytical skills in our short lifetimes is our responsibility to

each other and our wonderful world. That is what I mean by relativism: to

refine our knowledge and sensitivity, while at the same time realizing our

limits.

 

Yehuda

 

______________

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

Surf the web up to FIVE TIMES FASTER!

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[Guest guest]

> As far as Professor Worsley, I think that the combination of what he

> knew (within his self-limiting system), his charisma, and his focus

on > emotional-psychological-'spiritual' aspects of humanity (often

not > emphasized in other approaches) combined to make him a powerful

> healer. I see him more like a Mother Teresa figure, than, say, a

Dr. > Yoshio Manaka figure.

 

Frankly, I feel much the same way about Manaka. I believe his success

was mostly based on his personality and charisma as well as on his

personal enthusiasm.

 

Bob