Digest Number 1534/Source of Income

[Guest guest]

Bob F wrote

 

" 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. In other words, you can do

acupuncture based on any of a number of Oriental theories

(or Western

theories

 

All three of the Chinese practioners I've watched use

pretty much the same points for non-pain related syndromes,

no matter what the complaint, with one or two extra points

thrown in, according to the complaint. (eg-St 25 and Ren 12

for digestive) I don't mean to say they all use the same

points, but rather, that each of them has a series of

points that they use over and over. These points do not

seem to address blood xu vs bu, yin deficiency vs external

heat etc. Also, they hardly pay attention to the pulse or

tongue as far as I can tell. These are well-respected

doctors with good followings. One of them is a brilliant

Phd, and there is no doubt in my mind that he completely

understands syndrome differentiation, much more so then I

do. When he does the same points on everyone, I have to

conclude that the specific style of acupuncture doesn't

matter.

 

I hate the thought of that...I could have learned to needle

Sp9, St 36 and LI 10, and Liv 3 in a week.

 

I'm glad I have the herbal formulas to ruminate on.

 

G

 

 

 

 

 

[Guest guest]

, Gabrielle Mathieu wrote:

> I hate the thought of that...I could have learned to needle

> Sp9, St 36 and LI 10, and Liv 3 in a week.

>

> I'm glad I have the herbal formulas to ruminate on.

 

 

 

Herbs are hardly more complicated. From what I see in modern

translations, disorders can be reduced to about 20 or so of the same

herbal formulas, with some symptomatic variations if you use raw

herbs.

 

For most cases--say 85%--treatment is always simple. Who hasn't

heard marvelous and miraculous case histories from every type of

protocol. Even when teaching, I'm always amazed at which treatment

strategies practitioners use and still are able to change the pulses

for the better. It's probably that last 15% of difficult cases where

any real skill is demonstrated.

 

 

 

Jim Ramholz

[Guest guest]

While there certainly is more leeway in acupuncture/moxabustion than

with herbal medicine, it sounds like most of these practitioners are

either seeing too many patients or 'getting into a groove' (or a rut).

This is why I like a lot of the Japanese and traditional styles so

much, because of the amount of care and concentration put into

practice. . Granted, there is also the factor of point stimulus,

concentration, intention depth, technique and other levels of

interaction other than the choice of points. Perhaps it is the level

of training or esteem of acupuncture in our profession, but the fact is

that most patients are still perceiving acupuncture as the main

modality over herbal medicine. Therefore, we need to practice it at a

more sophisticated level or face a backlash in coming years as the

patient population becomes more sophisticated about Chinese medicine.

We can only coast on reputation for so long.

 

 

On Friday, July 25, 2003, at 03:39 PM, Gabrielle Mathieu wrote:

 

> All three of the Chinese practioners I've watched use

> pretty much the same points for non-pain related syndromes,

> no matter what the complaint, with one or two extra points

> thrown in, according to the complaint. (eg-St 25 and Ren 12

> for digestive) I don't mean to say they all use the same

> points, but rather, that each of them has a series of

> points that they use over and over. These points do not

> seem to address blood xu vs bu, yin deficiency vs external

> heat etc. Also, they hardly pay attention to the pulse or

> tongue as far as I can tell. These are well-respected

> doctors with good followings. One of them is a brilliant

> Phd, and there is no doubt in my mind that he completely

> understands syndrome differentiation, much more so then I

> do. When he does the same points on everyone, I have to

> conclude that the specific style of acupuncture doesn't

> matter.

>

> I hate the thought of that...I could have learned to needle

> Sp9, St 36 and LI 10, and Liv 3 in a week.

>

> I'm glad I have the herbal formulas to ruminate on.

>

> G

[Guest guest]

, " " wrote:

Therefore, we need to practice it at a more sophisticated level or

face a backlash in coming years as the patient population becomes

more sophisticated about Chinese medicine. >>>

 

> We can only coast on reputation for so long.>>>

 

 

 

 

Z'ev:

 

It was largely--if not solely--acupuncture's success in treatments

that raised CM to its present level of acceptence and popularity in

this country. What kind of backlash to you expect?

 

A great many styles of acupuncture--both simple and sophisticated--

are now taught and practiced. What will raise acupuncture to a still

more sophisticated level?

 

 

 

Jim Ramholz

[Guest guest]

, " James Ramholz "

<jramholz> wrote:

>

>

> Herbs are hardly more complicated. From what I see in modern

> translations, disorders can be reduced to about 20 or so of the

same

> herbal formulas, with some symptomatic variations if you use raw

> herbs.

>

> For most cases--say 85%--treatment is always simple.

 

Well, I only wish it was that simple, maybe you have found sound

magical system, or maybe I am missing something… What modern

translations are you referring to? I have never seen such a

simplified approach from any Chinese (and even English) internal

herbal books (even the so-called cook books).. Check out these two

translations from my website on depression (classical defined) and

cirrhosis of the liver...

 

Chinese Medicine/Articles_Pract/Depression%

20Table.htm

 

Chinese Medicine/Articles_Pract/cirrhosis.htm

 

I think maybe one is seeing simple approach b/c one's dx may be

simple. I.e. Under the disease heading of depression one can see not

only 17 different patterns, but the important thing is if one notes

the formulas (when the herbs are listed) they are already modified

for the pattern and the disease (meaning they are not just the

typical straight rx). Then on top of that they give modifications

for symptoms. Then it is up to the practitioner to see if all of the

herbs are necessary or see if any need to be added. Those

modifications and tweaks are of course the difficult part – and the

part that really makes a differnece. Just as Z'ev has mentioned (in

regard to acu), I meet people all the time that say I tried Chinese

herbs and nothing happened.. I inquire more and they were given some

bottle of something (patent rx, etc). Herbalist in China write

individualized Rxs. This is what the history and texts are based

on. I see no evidence that the style just giving people 1 of 20 Rxs

in used anywhere by `herbalists' except maybe in the states, where

training is minimal. Furthermore, most of the texts in China, theory

etc are all for herbs. This says something.

 

Interesting I was just talking to a shiatsu practitioner, who was so

excited b/c she just signed up for a course in Chinese herbs and now

was able to give Chinese herbs (formulas) in her practice. 1 class,

20 rxs I guess. – Do you think she can be as efficacious as an

experienced individualized raw herbalist. I seriously doubt it. Can

she cause harm, yes...

 

I will boldly say, IMO, I think herbs are much more complicated than

acupuncture, when it comes to mental rigor, training, and theory.

Acupuncture, IMO, requires something else, the magik, charisma,

technique, feeling a sense of qi, etc… I have seen practs with 2

years experience have such and get outstanding results. And as far

as `knowledge' they were lacking. So one can get wrapped up into

intricate theory with acu, but until that proves better results, I

will wait and focus on the magik. I think it is not hard to prove,

that individualizing herbal formulas are much more effective than 1

of 20 (IBS study). All the real herbalist I have worked with do this.

 

Most important is this: IN china what is the therapy of choice for

internal medicine problems : herbs , hands down. When acu is said to

have results in china it is usually given once, if not twice, a day.

This is not possible here. I am really skeptical that just

acupuncture once a week, can compete with herbs for internal medical

problems. (meaning making `real' changes') not just having the

person leave feeling better. This is purely based on the research

and methodology from the country we get our medicine, nothing more.

IF people have other information, please inform me…

 

Furthermore, as Bob has said, take away the acu and I would like to

see the results of just giving 20 formulas.. I know you are not

advocating this, and I am pushing this 20 rx thing, but people do

practice this way... So it is intersting to think about...

 

I compare writing herbal rxs to playing chess. Chess is easy on the

surface, and a move made by a master looks simple, but he/she is

seeing layers that the beginners cannot phathom. The move is only

revealed 10 moves down the line with a surprised capture, or huge

positional advantage.

 

 

I do agree with what you say below. But everyone like to talk about

there miraculous cases. But these results are far objective. There

are plenty of people that don't get better, that don't come back, and

somehow the practs forgets about that. I don't think someone just

poking in any point and giving 1 of 20 rxs can get a `real' 85%

success rate, but I may be wrong.

 

-

 

 

Who hasn't

> heard marvelous and miraculous case histories from every type of

> protocol. Even when teaching, I'm always amazed at which treatment

> strategies practitioners use and still are able to change the

pulses

> for the better. It's probably that last 15% of difficult cases

where

> any real skill is demonstrated.

>

>

>

> Jim Ramholz

[Guest guest]

, " " wrote:

I am really skeptical that just acupuncture once a week, can compete

with herbs for internal medical problems. (meaning making `real'

changes') not just having the person leave feeling better. >>>

 

Are you giving the person only one dose of herbs per week in this

comparison? That would be a mighty big bundle of herbs for one

weekly dose!

 

What are we really comparing in this thread between acupuncture and

herbs--other than one's popularity on this forum?

 

Since when isn't feeling better a real change? People feel better

because they are healthier. When a patient's pain disappears during

an acupuncture treatment, you don't think that is significant?

 

 

Jim Ramholz

[Guest guest]

, " " <

@h...> wrote:

 

>

> I think maybe one is seeing simple approach b/c one's dx may be

> simple. I.e. Under the disease heading of depression one can see not

> only 17 different patterns, but the important thing is if one notes

> the formulas (when the herbs are listed) they are already modified

> for the pattern and the disease (meaning they are not just the

> typical straight rx). Then on top of that they give modifications

> for symptoms. Then it is up to the practitioner to see if all of the

> herbs are necessary or see if any need to be added.

 

Jason

 

suffice it to say that I agree with everything you wrote. I want to pick up

this

point of the thread because it came up in class the other day. Philippe

Sionneau also includes many different chinese disease categories that may

be applicable to a single patient and then pretty much the largest number of

patterns within those complaints. Though clearly in comparison to the tables

on your website, he also was selective. Nevertheless, his books are quite

extensive and they reflect the very strategy you describe above in most cases.

that is to say he rarely indicates unmodified classical formulas. they are all

modified from the get go and additional modifications are suggested.

 

Some students found this disturbing. They felt that we should be learning to

modify classical formulas ourselves and not using already modified formulas.

They also felt the formulas were already complete and thus needed no further

tweaking. I felt this statement reflected a failure to understand several

things

which I clarified (hopefully).

 

There is the issue of disease and pattern differentiation. That there are

standard modifications for classical formulas based upon their use in a given

disease. these modified formulas have also been passed down through the

centuries. Just as it would be foolhardy to abandon classical formulas as a

guide to practice, it would also be shortsighted to not consider the standard

modifications that also have a lot of consensus in many cases. Otherwise we

are wasting time reinventing the wheel. Since what we are doing is medicine,

unlike other arts, our primary duty is to do what is generally considered to

work in a practical fashion (whereas arts such as music and sculpture need

not be practical). There is still always quite a challenge and the opportunity

for creativity in herbal prescribing, but it is not infinite in this regard.

 

I think any experienced herbalist would see that these modifications in

Sionneau are not mysterious and in fact are quite typical and very useful

guides. Jason is right that one still has to decide whether to add or delete

and

adjust dosage in any case. Even if the formula appears " complete " for the

patient in that it has herbs that address all the treatment principles, it still

may

be necessary to accentuate functions of one or more herbs already present

for a variety of reasons. And if Sionneau (or a similarly formatted internal

medicine book) does not list adequate modifications for your case, you will

need to seek herbs and combinations from other sources like materia

medicas or formularies (like Bensky). Or consider combining part or whole of

another formula into your base formula.

 

That being said, you don't have to practice that way to get good results in your

practice. You can practice more cookbook or even shotgun if your patient is

doing mutiple therapies. what seems to be the mitigating factor in my

observation is that many of those who practice this way use some form of

prepared medicine at low to moderate doses. If their diagnosis is correct, they

do no harm and perhaps some good. But as I have stated many times, when

relying primarily on herbs for patient care, I rarely see signficant and rapid

symptomatic changes using prepared medicines. Only high dose decoctions

or high quality powder equivalents. That is my experience.

 

In order to achieve my clinical goals, I must rely on use of herbs in this way.

Women who are profusely bleeding or suicidally depressed need help now,

not next week or month. The higher you dose, the more you risk side effects.

dosing high without side effects is much more difficult than what Jim portrays

in his post describing the practice of herbology, IMO. If one does not practice

this way I describe and the way in which I know Jason practices, I do not

believe one has really wrestled with this issue. Where slight adjustments in

dosage or the addition or deletion of a single herb makes all the difference in

the world.

 

That all being said, I believe it is still also unproven whether practicing

herbal

medicine by pattern differentiation is superior to practicing it allopathically.

considerable chinese and japanese research show high success rates with

allopathic style research, as high as those that use pattern diff. Even the IBS

study Jason mentioned had mixed results - better short term relief with the

allopathic approach and better long term with TCM. And really little overall

difference even in that latter regard. However the difference between using

the wrong high dose raw herb formula (whether done allopathically or TCM

style) versus using a less efficacious acupuncture technique or a low dose

patent is that in the latter cases, at least one does not harm the patient, just

fails to get them well effectively (which is a type of harm, perhaps??). I am

making an assumption from a prior post here that it might be proven that

certain styles were more effective for certain complaints than others (such as

perhaps ortho styles for neuro dz.).

 

The point is depending on how one practices, what type of patients one sees

and what clinical goals one has, the practice of herbology can clearly range

from simplistic to complex. And in when it comes to high dose prescribing, if

one does not grasp the entire complexity of the subject, one will easily injur

the patient. the only reason that this is not a widespread public health

hazard

is that most such practitioners do not prescribe raw herbs anyway. On the

other hand, I have seen quite inexperienced practitioners get excellent results

with acupuncture time and time again even when I believe they do not yet

understand the full complexity of the patients they are dealing with and

despite often being quite simplistic and formulaic in their treatments (which I

am admittedly also in my acupuncture treatments because it seems to work so

well, so no offense intended, and because all my mental time and energy is

consumed by the complexity of the herb issues to which I speak here). And at

the very least, they get generalized health benfits and do not harm the patient.

 

[Guest guest]

, " James Ramholz "

<jramholz> wrote:

> Are you giving the person only one dose of herbs per week in this

> comparison? That would be a mighty big bundle of herbs for one

> weekly dose!

>

 

Well you are absolutely right... We do not give 1 dose of herbs for 1

week... we will give 2-4x day for a week, and this is precisely my

point… This is 1 reason why I feel herbs are superior for internal

medicine complaints. Do you give acupuncture 2-3 day for a week or

two? Who can afford this… Maybe acupuncture is as effective if one

can give it so often, but it is not possible, so the argument seems

moot… Although if we look at China, they do have the option of giving

acupuncture this often, but yet they still give herbs for the

majority of internal medicine complaints (in the hospitals) (and from

my limited knowledge, the majority of the time without acupuncture).

This says to me that herbs are more efficacious that acupuncture for

these issues. What else do I have to go on…? So this comparison

does not have to do with anything about the popularity of this forum,

just what I have observed in my clinic, training, and read and heard

from Chinese docs from china. I am open to new information…

 

 

 

> What are we really comparing in this thread between acupuncture and

> herbs--other than one's popularity on this forum?

>

> Since when isn't feeling better a real change? People feel better

> because they are healthier. When a patient's pain disappears during

> an acupuncture treatment, you don't think that is significant?

 

I don't 100% agree… My observation is that with acupuncture it is

real easy to have a person with almost any complaint feel better

before they leave the office. But the question is, How long does

this `feeling' last, and did it take care of the root problem. In

the California Laws & regulations 2nd paragraph it says, under

legislative intent " in its concern with the need to eliminate the

fundamental causes of illness, not simply remove symptoms, and the

need to treat the whole person… "

 

I have seen many people change pulses, which again I do not find that

difficult, while the person is there. But how long does that pulse

change? and what does this even mean? I have seen amazing pain

relief from strange Japanese needling, but only for it to return in

less than 24 hours. Sure if people feel better for 4 weeks after an

acu tx, that is great. But this seems to be the exception not the

rule… Also a good % of my patients want real changes, lab values etc…

They want there condition improved… If someone takes an aspirin and

there pain goes away, does this mean they are healthier? I believe

not… Acupuncture is known to release endorphins among other things,

acu has a natural analgesic effect, so it is no surprise that acu

relieves pain (in the short term)...

 

I also doubt the ability of acupuncture to actually strengthen

vacuities… I see it able to move qi, calm the spirit (etc) very well,

hence this is why people feel better so quickly, and also why it

usually doesn't last that long… again if it was so powerful, why

don't the Chinese use it for the serious diseases…

 

 

-

[Guest guest]

> , " James Ramholz "

> <jramholz> wrote:

 

>

> > What are we really comparing in this thread between acupuncture and

> > herbs--other than one's popularity on this forum?

 

you know. that's just ludicrous. many of the most prominent posters on this

list are very ardent acupuncturists, including Will, Z'ev, Marnae, Rory, Alon

and yourself. You are trying to dismiss this thread with a straw man attack

against the list. I am personally not an ardent acupuncturist. But I often

reflect minority opinions on this list on controversial issues. And as everyone

knows, I often play devil's advocate for the sake of drawing out argument. But

in some cases, all that seems to emerge is anecdote and a priori bias. I say

again, let's study the matter, let the chips fall where they may and I will side

with the evidence. Oh and acupuncture works. I see that every day.

 

[Guest guest]

, " "

<@h...> wrote:

>

> I also doubt the ability of acupuncture to actually strengthen

> vacuities… I see it able to move qi, calm the spirit (etc) very

well,

> hence this is why people feel better so quickly, and also why it

> usually doesn't last that long… again if it was so powerful, why

> don't the Chinese use it for the serious diseases…

>

>

 

funny, another Ogawa opinion: he said that acumoxa was more of a

supplementing therapy, where herbal medicine was better for

draining ... of course, may just reflect SHL-driven mainstream Kampo.

 

BTW, be careful of your arguments... AFAICT the Chinese routinely mix

WM pharmaceuticals w/ or w/o zhongyao for their REALLY serious

diseases... so if herbs are so powerful, why do they use drugs?

 

rh

[Guest guest]

, " kampo36 " <kampo36>

wrote:

> , " "

> <@h...> wrote:

> >

> > I also doubt the ability of acupuncture to actually strengthen

> > vacuities… I see it able to move qi, calm the spirit (etc) very

> well,

> > hence this is why people feel better so quickly, and also why it

> > usually doesn't last that long… again if it was so powerful, why

> > don't the Chinese use it for the serious diseases…

> >

> >

>

> funny, another Ogawa opinion: he said that acumoxa was more of a

> supplementing therapy, where herbal medicine was better for

> draining ... of course, may just reflect SHL-driven mainstream

Kampo.

 

That is interesting… and maybe this is a SHL bias, since the main

objective in that school of thought is to eliminate a pathogen. And

I agree and think that moxa does have a supplementing property, I was

actually just referring to acupuncture. But I am open to more

evidence on that… I like as many of you may have figured out,

like to play devil's advocate to hear the other side to arguemtns, to

help me make up my mind.

 

>

> BTW, be careful of your arguments... AFAICT the Chinese routinely

mix

> WM pharmaceuticals w/ or w/o zhongyao for their REALLY serious

> diseases... so if herbs are so powerful, why do they use drugs?

 

I think drugs are more `powerful' than herbs… And I actually like the

idea of mixing therapies, in appropriate situations… This is a big

topic, when a given therapy(ies) appropriate and not appropriate…

and actually after I posted that msg., I meant to say internal

medicine diseases since that what I was previously taking about

(`serious' was a loaded word)… but the question still centers around

acupuncture's place in this medicine (and I don't see how the use or

non-use of pharmaceuticals impacts that discussion)…

 

-

[Guest guest]

, " " <@i...>

wrote:

Oh and acupuncture works. I see that every day.

 

 

 

 

I am curious, since you see much more cases of just acupuncture (no

herbs) than I get to see, what is your take on the efficacy of actual

change in internal medicine complaints? How long do you feel results

last? And how do you define `success', 'works', or `good results' in

the PCOM clinic?

 

-

[Guest guest]

, " "

<@h...> wrote:

> > That is interesting… and maybe this is a SHL bias, since the main

> objective in that school of thought is to eliminate a pathogen.

And

> I agree and think that moxa does have a supplementing property, I

was

> actually just referring to acupuncture. But I am open to more

> evidence on that… I like as many of you may have figured out,

> like to play devil's advocate to hear the other side to arguemtns,

to

> help me make up my mind.

 

My experience is that Japanese-style direct moxibustion is the MOST

powerful somatic therapy i've tried... but that's just my experience.

The Sawada whole-body moxibustion protocol is probably what i use

most for complex internal problems (besides kampo/CHM of course).

 

>

> > > I think drugs are more `powerful' than herbs… And I actually

like the

> idea of mixing therapies, in appropriate situations… This is a big

> topic, when a given therapy(ies) appropriate and not appropriate…

> and actually after I posted that msg., I meant to say internal

> medicine diseases since that what I was previously taking about

> (`serious' was a loaded word)… but the question still centers

around

> acupuncture's place in this medicine (and I don't see how the use

or

> non-use of pharmaceuticals impacts that discussion)…

>

> -

 

 

oh, i'm just pointing to the logical extension of your argument, i

can't say i disagree with much of what you've said. it just sort of

sounded like you were bashing acumoxa, though i know that wasn't your

intention. i think everyone on the list (yourself included) can

point to experiences in which AM proved to be remarkably effective in

internal cases. but IMHO it IS a different skill set from CHM and

individuals truly gifted in both are rare.

 

that having been said, i can't help but get the sinking feeling that

Jim is right in his view that the old-school compounding herbalist is

an endangered species in the healthcare wilderness. reimbursement

tends to be procedure-based, and acumoxa fills that bill pretty well,

so i think its place is probably more secure than that of zhongyao.

i'm just catching up with the rest of the list in reading Volker

Scheid's book, and it seems that even in China many patients resist

decoctions and frequently self-prescribe prepared medicines. so in

this sense are we spending our time and energy teaching our students

what may well soon become an anachronistic practice in wriing

prescriptions? i hope not, but then again, the winds seem to be

shifting in that direction.

 

robert hayden

[Guest guest]

, " " <@h...>

wrote:

 

>

>

> I am curious, since you see much more cases of just acupuncture (no

> herbs) than I get to see, what is your take on the efficacy of actual

> change in internal medicine complaints? How long do you feel results

> last? And how do you define `success', 'works', or `good results' in

> the PCOM clinic?

 

 

I believe I see long lasting changes in IBS, PMS, bloating, constipation,

insomnia, depression, anxiety. Success in these cases is measured by long term

followup. There are many patients at PCOM who originally came with

complaints such as these and now return occasionally for other complaints.

However, there may be other factors in the cases I refer to that were as or

more instrumental in cure than acupuncture. Such as weight loss, diet change,

self medication with various supplements, exercise, yoga, etc. But isn't that

the

case with herbology, too?

 

I think I regularly see more sustained changes with herbology than acu, but

perhaps that is merely due to twice daily reinforcement. If one received

acupuncture with sufficient frequent reinforcement, one could also perhaps

expect such results. However that would not be cost effective in America or

would it? If you got 30 daily treatments at $60 a pop, that would be $1800 a

month, clearly more than any insurance company would reimburse on a

regular basis. On the other hand, if acus were employed by hospitals at say

$40 per hour and saw three patients per hour, each office visit would cost the

insurer more like $13. That would cut costs by almost 80%. that's doable.

 

And $40 per hour is more than most people make in private practice for a long

time, if ever. Sure you could make a lot more if you could see 3/hour in

private, but again most people don't. 40 per hour is $80 grand per year

fulltime, BTW. Would people work for this wage? I think a lot of folks would

prefer this to running a business. If you worked for Kaiser at this rate and

had full benefits for your family, you would be making the equivalent of 100

grand with the cost of health insurance factored in. I think a lot of energy is

being devoted to elevate the profession to doctor in name, but the focus is

still

mainly on the private practice model. We want to compete on level ground.

 

However, maybe there are progressives amongst you who would prefer to be

employees in a single payer system instead. Since I don't have a private

practice, I am speaking merely to pose an alternative to the current healthcare

crisis. We have gone from one disaster (fee for service) into another (managed

care). Healthcare costs are still skyrocketing and I got into TCM because I

wanted to do something about this burden that contributes to the current

crippling of our economy. 40 million people have no access besides emergency

rooms. The only option widely used in the rest of the world and not used here

yet is the single payer option. People could still have private practices.

They

are currently elitist anyway and the elite would continue to use them to avoid

the masses. I think directing our energy towards this end would yield the

most societal and economic benefits for us and our patients. while there

might be less opportunity for some to get filthy rich, there could be much

more opportunity for most to make a decent living.

 

[Guest guest]

, " " wrote:

> you know. that's just ludicrous. many of the most prominent

posters on this list are very ardent acupuncturists, including Will,

Z'ev, Marnae, Rory, Alon and yourself. You are trying to dismiss

this thread with a straw man attack against the list. I am

personally not an ardent acupuncturist. But I often reflect minority

opinions on this list on controversial issues. And as everyone

knows, I often play devil's advocate for the sake of drawing out

argument. But in some cases, all that seems to emerge is anecdote

and a priori bias. I say again, let's study the matter, let the

chips fall where they may and I will side with the evidence. Oh and

acupuncture works. I see that every day.

 

 

:

 

" Ludicrous? " Maybe so. From my perspective, the arguments about

acupuncture have been also sounded anecdotal and with an apriori

bias--hence my comment. I am reading a mixture meanings in messages

that, on one hand, dismisses acupuncture as " magik and charima " or

people feel better but don't really get better and, on the other,

say " Oh and acupuncture works. I see that every day. "

 

Saying that acupuncture has less efficacy because its used less

often in China is a fallacious argument. There are probably many

other historical reasons why acupuncture in China is unsophisticated

and less often used. I don't do Chinese-style acupuncture; I studied

with a Korean. My experience with acupuncture is, then, probably

very different from those that were trained in the Chinese style. I

would guess that Will, Z'ev, Marnae, Rory, and Alon also might have

different experiences regarding the efficacy of acupuncture if they

use it in their practices. Keep in mind that it was acupuncture that

created the real interest in CM around this country.

 

Of course, it would be interesting to do a study to see what's what.

I agree, let's study the matter, let the chips fall where they may

and side with the evidence. Perhaps medical acupuncturists have

already done some of these. But I doubt we'll see much difference in

the success rate whether whether practitioners primarily use

acupuncture, use both acupuncture and herbs, or primarily use herbs.

I may be wrong--it wouldn't be the first time.

 

And I am often wondering whether the success rate in many of the

herbal case studies from China can actually be duplicated. But that

is another controversial issue.

 

 

Jim Ramholz

[Guest guest]

--- < wrote:

" And $40 per hour is more than most people make in

private practice for a long time, if ever. Sure you

could make a lot more if you could see 3/hour in

private, but again most people don't. 40 per hour is

$80 grand per year fulltime, BTW. Would people work

for this wage? I think a lot of folks would prefer

this to running a business. If you worked for Kaiser

at this rate and had full benefits for your family,

you would be making the equivalent of 100 grand with

the cost of health insurance factored in. "

 

 

Hi

 

I think you'd have a boat-load of people lining up to

make an annual salary of $80k + benefits. I will

always remember one of my TCM Chinese professors (who

saw between 100-150 px. per week depending on the time

of year) saying during a 3rd year elective: " 60% of

people who graduate will not be in practice after 5

years. " And if that's true, what are these people

doing now? And what are they earning? Back in 1999,

I was offered a position at a hospital in Des Moines,

IA. Do you know what salary they offered? $42k +

benefits. I think there are a lot of people who might

take that if it was offered today. Obviously, anyone

who has a somewhat successful practice might turn

their nose up at the above. But, as we've discussed

in the past, you really have to add in health benefits

and other costs to come up with an " adjusted salary. "

Obviously, at this time in our profession, a person

could work at a clinic at it could be shut down after

a year or two. But, putting that aside, what would

people accept as a base salary?

 

Regards.

 

Eric

 

 

 

 

 

 

[Guest guest]

Eric, and others interested,

 

I don't know what salaries are like

today, but a few years ago when I

was working with one of the board

members at Cedars Sinai in LA, the

going rate for a neuro-surgeon just

out of med school/residency, i.e., a

new hire, was between 90 and 100K.

 

I hate to be the one to break the

news, but having an LAc is not

a guarantee of the good life.

 

The whole business of medicine has

gone through quite an astonishing

period of redefinition and reorganization

over the past decade or so.

 

I continue to believe that if one

were truly interested in doing any

and everything one might to increase

one's likelihood of surviving well

as a practitioner of Chinese medicine,

one would strengthen one's grasp of

the powerfully potent roots of the

subject that have sustained it over

the past few millennia.

 

Nothing survives like survival.

 

I think it is a big mistake to allow

our reality to become denominated in

dollars...or any other currency, except

the currency of care and of taking care

of the people around us...and of ourselves.

 

This taking care, in the paradigm of

Chinese medicine (to invent a new phrase)

begins and ends in the cultivation of

qi.

 

As I told a friend of mine the other day

there are just two reasons why one does

not cultivate one's qi:

 

1. don't know what to do; or

2. lazy

 

So don't be too alarmed if you're not

making $100,000.00 per year and sending

your kids to a private school.

 

It is, no doubt, generally true that

life, like the old song says, if but

a dream. But that life definitely seems

to be a dream that has already faded from

reality...if not memory.

 

Ken

[Guest guest]

, Eric Popp <epopp3267>

wrote:

 

> > I think it is a big mistake to allow

> > our reality to become denominated in

> > dollars...or any other currency, except

> > the currency of care and of taking care

> > of the people around us...and of ourselves.

 

 

I actually agree and I do not participate in the gathering of money as an end in

itself. I do what I enjoy and it is not very lucrative for me. However there

has been much talk of late about education and degrees and titles (not just

here), much of which I think is transparently geared towards personal

economic gain with little thought of society or the greater good. While what I

propose might sound greedy to some, it is actually not a large amount of

money for a family of 4 in socal, especially if one parent does mostly

childcare.

And just about every recent grad I know would be horrified to hear that if

they ever average $40 or more per hour in a true 40 hour week (not 40 hours

of patients and 20 of business and paperwork), they are a rare exception. The

most successful large clinic in town tells his associates they will be doing

good

when they average $33 per hour (and that does not include time spent

marketing or anything besides patient care). Most people are expecting to

bank gold. I think if we set our sights lower and aimed for the common good

instead of personal gain, a lot more people would be happy even if no one got

rich (oh my, that sounds so socialist; like I care)

 

[Guest guest]

In a message dated 7/28/03 12:52:36 PM, writes:

 

 

However there

has been much talk of late about education and degrees and titles (not just

here), much of which I think is transparently geared towards personal

economic gain with little thought of society or the greater good.

 

 

I strongly disagree. Having been on the forefront of the movement towards a more complete education in our field, it is my impression that those who wish to advance the degrees and the resultant title(s) in our field have the best intentions and hopes of a competent and comprehensive field of medicine for the future.

Of course, there could be a focus on ego (title or degree), or knowing what they lack from personal knowledge and wishing to provide that for the future of the profession (degree), or utility for comparison against other professions with similar training or scope (title).

I dont' see where greed comes in when one is proposing more comprehensive education for future generations of practitioners who will make them (the proposers or further education) look stupid if they don't double (or more) their required CEU load to keep on top of their game.

David Molony