entry level DAOM

[Guest guest]

, Al Stone <alstone@b...> wrote:

We decided that we can wear that white

> lab coat, but in the hearts and minds of our patients, we still don't

> have that credibility that the MD's do.

>

> Perhaps the doctorate will help to change that. Something needs to.

>

 

I think a doctorate w/o an extensive residency is bogus. Master's internship

is already a joke in the amount of case management a student learns from only

250 patient visits (50% neuromuscular, 15% stress related, less than 1-3% of

any other type of case, such as GYN, RESP, for example). A DAOM internship

wouldn't be a whole lot more, maybe 500 at the most. the number should be in

the thousands. I don't see how a pretty much bogus doctorate can help our

credibility. We already have more credibility than either ND's or DC's, both

doctors. I think DCs and ND's are often regarded as bogus by MDs in part

because their training is so skimpy. It may actually diminish our credibility

if we reach for a title that is considered ludicrous in most mainstream

circles. Here in san diego, most folks I meet still think practicing

acupuncture is for new age freaks. they might try it if nothing else works,

but they still think we are freaks. I think that would just make us Dr. Freak.

 

I cannot think of a worse scenario for the profession and society than to go to

an entry level doctoral degree and I questionthe wisdom of having a doctoral

level at all. It will cost students and patients and insurers more money and

will not likely increase the quality of care; it may even jeopardize the

public's health if legions of patients start seeing recent DAOM grads and

desert seasoned vets who don't want to go back to school (and spend big

bucks) to learn nothing of clinical value. I think Roger is right that we

should

be content with the least regulation and titling we can have and still ply our

trade. Unless increased education leads to better patient results or

increased scope, it serves no purpose. It also gives a misleading impression

to the public, that those with the title are superior, when in fact, it is

likely

the opposite. All else being equal, those who who have been in practice for

many years and are busy with patients are probably more skillful than those

who entered school in 2001 and will go straight through to their DAOM by

2006.

 

[Guest guest]

A DAOM internship

wouldn't be a whole lot more, maybe 500 at the most. the number should be in

the thousands

>>>It should be in china were one can see some sick people in meaningful numbers

Alon

 

 

[Guest guest]

At 7:05 PM -0500 5/2/04, Alon Marcus wrote:

>A DAOM internship

>wouldn't be a whole lot more, maybe 500 at the most. the number should be in

>the thousands

> >>>It should be in china were one can see some sick people in

>meaningful numbers

--

Foreign students in China, who are not in a regular Chinese training

program, generally only get to observe treatment, and this wouldn't

qualify as internship patient treatments. Do you think Chinese

teaching hospitals would allow our trainees to function as treating

interns? Would Chinese patients be likely to seek treatment from them?

 

Would it be legal for US schools to require students to attend

internship in China?

 

Rory

--

 

 

 

[Guest guest]

Yes, teaching clinics would allow students treat their patients. But remember

that

their facilities are much different. They generally don't go one on one with an

intern

in a private room for 30 minutes before calling the supervisor.

And yes, the patients are not real happy about being treated by students with

less

experience. How much is based on the Western face I don't know.

I agree that a Chinese internship is vital. It's like loving baseball, you

eventually want to see Yankee Stadium or loving Opera and going to Vienna.

doug

 

 

 

, Rory Kerr <rorykerr@o...> wrote:

> At 7:05 PM -0500 5/2/04, Alon Marcus wrote:

> >A DAOM internship

> >wouldn't be a whole lot more, maybe 500 at the most. the number should be in

> >the thousands

> > >>>It should be in china were one can see some sick people in

> >meaningful numbers

> --

> Foreign students in China, who are not in a regular Chinese training

> program, generally only get to observe treatment, and this wouldn't

> qualify as internship patient treatments. Do you think Chinese

> teaching hospitals would allow our trainees to function as treating

> interns? Would Chinese patients be likely to seek treatment from them?

>

> Would it be legal for US schools to require students to attend

> internship in China?

>

> Rory

> --

>

>

>

[Guest guest]

At 2:17 PM +0000 5/3/04, wrote:

>Yes, teaching clinics would allow students treat their patients.

--

How do you know that?

 

 

>But remember that their facilities are much different. They

>generally don't go one on one with an intern in a private room for

>30 minutes before calling the supervisor.

--

To say nothing of the need for expert translators, who would have to

ensure that the nuances of diagnosis information were properly

transmitted between each intern, their patients, and their

supervisors.

 

Rory

--

 

 

 

[Guest guest]

On May 2, 2004, at 4:26 PM, wrote:

 

> , Al Stone <alstone@b...>

> wrote:

> We decided that we can wear that white

>> lab coat, but in the hearts and minds of our patients, we still don't

>> have that credibility that the MD's do.

>>

>> Perhaps the doctorate will help to change that. Something needs to.

>>

>

> Unless increased education leads to better patient results or

> increased scope, it serves no purpose. It also gives a misleading

> impression

> to the public, that those with the title are superior, when in fact,

> it is likely

> the opposite. All else being equal, those who who have been in

> practice for

> many years and are busy with patients are probably more skillful than

> those

> who entered school in 2001 and will go straight through to their DAOM

> by

> 2006.

 

Probably the recent grads (who begin with the DAOM) will be better

practitioners than we were during our first year. That's one benefit,

the other is the use of the word " doctor " . Perhaps it will take more

than that to really bring our profession up to the compliance that

biomedicine appears to have with the world's patients. I don't know,

but I do know that I've got patients who were on drug X for 2 years

without any results, change, or benefit.

 

If they stick with an herbal regimen for six months, they've totally

got my respect. However, by this definition, the number of patients

that I respect is very small.

 

I did get a nice bit of feedback this past week, though. My mother was

on hormone replacement therapy and was even part of that big research

project that discovered a link between taking two hormones and breast

cancer. My mother even got the breast cancer. (She's all better now...)

 

But in the meantime, she suffered from a detached retina. Since she

didn't have her HRT anymore, she got serious about herbs. I gave her

Ming Mu Di Huang Wan. She's been on it for something like nine months.

Her hot flashes are gone, menopausal issues are non-existent. That

happened pretty quickly, but in time her retina too has been improving.

Apparently it is doing so well that her ophthalmologist wants to know

what she's taking... I gladly wrote up a little Rx. synopsis last week

for him.

 

Moral of the story here is that long-term herb use does give rise to

some remarkable healings. It is unfortunately very rare that I can

witness this kind of response simply because I don't have the clout

that the MD with his or her drugs has. My patients are slow to stick

with herbs for that long. It is very rare indeed.

 

 

--

 

Pain is inevitable, suffering is optional.

-Adlai Stevenson

[Guest guest]

One acupuncturist who does a lot of insurance and court work about

acupuncturists

(law suits) says that the ones who are causing the most trouble with

pneumothorax/

safety issues etc... are the " more experienced " acupuncturists. In other words,

it is

education and not experience that makes our trade safer. He says it is not a

matter of

more law suits over the years, it is simply the amount of education the

acupuncturists

have had.

 

doug

 

 

> Al (I think) wrote:

> Probably the recent grads (who begin with the DAOM) will be better

> practitioners than we were during our first year.

[Guest guest]

, Rory Kerr <rorykerr@o...> wrote:

> At 2:17 PM +0000 5/3/04, wrote:

> >Yes, teaching clinics would allow students treat their patients.

> --

> How do you know that?

>

In every clinic I've been in China (which is only half a dozen) they are

perfectly willing

to hand over their needles to let you " practice " .

 

>

> >But remember that their facilities are much different. They

> >generally don't go one on one with an intern in a private room for

> >30 minutes before calling the supervisor.

> --

> To say nothing of the need for expert translators, who would have to

> ensure that the nuances of diagnosis information were properly

> transmitted between each intern, their patients, and their

> supervisors.

 

Again I don't know if you've been in a Chinese Clinic but nuances are not a big

deal

there. We are talking about acupuncture here. With herbs it takes years of

experience

at the " old doctors " side to be allowed to write a formua. this goes for Chinese

or

Western students and recent graduates.

doug

 

>

> Rory

> --

>

>

>

[Guest guest]

On May 3, 2004, at 4:08 PM, wrote:

 

> One acupuncturist who does a lot of insurance and court work about

> acupuncturists

> (law suits) says that the ones who are causing the most trouble with

> pneumothorax/

> safety issues etc... are the " more experienced " acupuncturists. In

> other words, it is

> education and not experience that makes our trade safer. He says it is

> not a matter of

> more law suits over the years, it is simply the amount of education

> the acupuncturists

> have had.

 

We could interpret this to suggest that the busier you are, the less

careful you are as well.

 

--

 

Pain is inevitable, suffering is optional.

-Adlai Stevenson

[Guest guest]

At 11:11 PM +0000 5/3/04, wrote:

>Again I don't know if you've been in a Chinese Clinic but nuances

>are not a big deal there. We are talking about acupuncture here.

>With herbs it takes years of experience at the " old doctors " side to

>be allowed to write a formua. this goes for Chinese or Western

>students and recent graduates.

--

 

Doug,

 

I guess we've been speaking of different things. I was speaking only

of herbal clinic, or at least combined herbs and acupuncture. The

call for more internship treatments has to include both surely.

 

For the training to be meaningful, interns would have to have

responsibility for diagnosis and treatment planning, as well as the

therapy itself, not just placing a few needles at someone else's

discretion.

 

Rory

--

 

 

 

[Guest guest]

Again I don't know if you've been in a Chinese Clinic but nuances are not a big

deal

there. We are talking about acupuncture here. With herbs it takes years of

experience

at the " old doctors " side to be allowed to write a formua. this goes for Chinese

or

Western students and recent graduates.

>>>>I think it depends were. In 1985 i was the one writing the herbal Rx 3

mornings a week and the Dr's were criticing them. All the other times i just

followed them

Alon

 

 

[Guest guest]

Doug wrote:

<<<I agree that a Chinese internship is vital. It's like loving baseball, you

eventually want to see Yankee Stadium or loving Opera and going to Vienna.>>>

 

While this may be desireable, its definitely not practical. I don't think the

average adult student is in a position to just pick up and go overseas for a

year or two, whether its desireable or not. This might be doable for a single

student without other obligations, but not so likely for those adults with

families and other obligations. A requirement like this would prevent many

very capable students from going any further. I don't see that helping the

profession at all.

 

I think the real key is *what* is covered by additional training, and *how*

it may be structured to advance the acupuncturist's knowledge and ability, not

per se, where the training is taking place. Hands-on clinical application is

certainly one area, but practice management, herbal biochemistry, advanced

theraputics and other areas of training would be equally useful. I don't think

travel to China is vital for such advanced training to take place. Its simply

a matter of designing a strong program that better prepares the acupuncture

student for the practice of Oriental Medicine as a primary practitioner, and

devising a structure on par with that of Western Medicine programs. If we want

to be accepted right along with Western Doctors, our training must be equally

comprehensive, although certainly unique to us.

 

Kindest Regards,

 

Andrea

 

 

 

 

[Guest guest]

He was pretty clear it wasn't about patient load but the amount of education....

doug

 

, Al Stone <alstone@b...> wrote:

We could interpret this to suggest that the busier you are, the less

> careful you are as well.

>

> --

>

> Pain is inevitable, suffering is optional.

> -Adlai Stevenson>

 

 

 

> On May 3, 2004, at 4:08 PM, wrote:

>

> > One acupuncturist who does a lot of insurance and court work about

> > acupuncturists

> > (law suits) says that the ones who are causing the most trouble with

> > pneumothorax/

> > safety issues etc... are the " more experienced " acupuncturists. In

> > other words, it is

> > education and not experience that makes our trade safer. He says it is

> > not a matter of

> > more law suits over the years, it is simply the amount of education

> > the acupuncturists

> > have had.

>

> We could interpret this to suggest that the busier you are, the less

> careful you are as well.

>

> --

>

> Pain is inevitable, suffering is optional.

> -Adlai Stevenson

[Guest guest]

Rory and Alon, I'll put an email in to Steve Given who has been taking students

to

Shanghai with the Bastyr group...

doug

 

, " Alon Marcus " <alonmarcus@w...>

wrote:

> Again I don't know if you've been in a Chinese Clinic but nuances are not a

big deal

> there. We are talking about acupuncture here. With herbs it takes years of

experience

> at the " old doctors " side to be allowed to write a formua. this goes for

Chinese or

> Western students and recent graduates.

> >>>>I think it depends were. In 1985 i was the one writing the herbal Rx 3

mornings a week and the Dr's were criticing them. All the other times i just

followed

them

> Alon

>

>

[Guest guest]

Yes, teaching clinics would allow students treat their patients. But remember

that

their facilities are much different.

>>>>When i was in china i studied and worked in a municipal hospital not a

teaching clinic or hospital. I would think there is much flexibility in

posibilites

Alon

 

 

[Guest guest]

To say nothing of the need for expert translators, who would have to

ensure that the nuances of diagnosis information were properly

transmitted between each intern, their patients, and their

supervisors.

>>>>Again I do not know how things are now. But I had a TCM Dr that spoke fairly

good English as a translator. It worked quite well

Alon

 

 

[Guest guest]

By the way, I trained in a municipal hospital not a teaching clinic or teaching

hospital.

Alon

 

 

[Guest guest]

At 7:52 AM -0700 5/4/04, alon marcus wrote:

>To say nothing of the need for expert translators, who would have to

>ensure that the nuances of diagnosis information were properly

>transmitted between each intern, their patients, and their

>supervisors.

> >>>>Again I do not know how things are now. But I had a TCM Dr that

>spoke fairly good English as a translator. It worked quite well

--

 

Right, that's my experience also.

 

However, if a college sends say 10 interns to a hospital, I'm

wondering if there is even one hospital in China that has 10 doctors

with sufficient English skills, let alone are they willing to perform

this function. What works for groups of say one to four foreigners

observing a Chinese doctor and transmitting only essential elements

of the case, is not at all the same as what would be necessary for

interns who have responsibility for conducting interviews, and doing

diagnosis and treatment planning.

 

I'm not saying it could not be done, and it's worth working toward,

but it is not so easy a solution as some are suggesting.

 

Rory

--

 

 

 

[Guest guest]

I'm wondering if it is indeed inconceivable to establish high volume

specialty CM internships here in the States. I work in the radiation

oncology department of a hospital in Milwaukee - not by any means a

city known for widespread interest in .

Nevertheless, over 65% of new patients express interest in

incorporating acupuncture and other forms of CAM into their

treatment. (And many of those who are not interested at first become

more open to the idea once they start experiencing side effects.) So

at least within oncology, the patients are there. We would need to

find and cultivate cooporative institutions and physicians, and CM

practitioners who are experienced in various specialties. It may not

be realistic for next year, but what about in 5 years?

 

Adam Margolis

[Guest guest]

What works for groups of say one to four foreigners

observing a Chinese doctor and transmitting only essential elements

of the case,

>>>As i said, three morning a week i functioned as the Dr, did the Dx, and wrote

the Rx. So they were able to translate all the information i felt was needed.

Its true however, there were only about 8 Dr. in that hospital that spoke

English, only 4 of them well.I would think it would not be expensive to hire

English majors as translators.

Alon

 

 

[Guest guest]

Hiring english majors will not cut it at all. During my internship we

had masters students or PhD students as translators in the outpatient

clinic. 9 out of 10 were not up to the task even though they had

trained for the job and it added a year or two to their masters or PhD

studies.

 

People with good english skills in china are poached by companies who

pay them several times the wage they would get in a hospital. Nanjing

Uni has great difficulty keeping any of the translators it trains. THey

find plentiful and higher paying work elsewhere in China or leave to

study or practice overseas.

 

Teaching hospitals in my experience do NOT let you treat patients with

herbs. You are lucky if you get a few complete and understandable

translated cases in a day. It is sooooo busy there that they simply

don't have time to go into any details and the average translator

simplifies things to the point of uselessness anyway.

 

I did have the opportunity to work with 2 doctors who had good english

skills. One in dermatology and one in acupuncture. This made a HUGE

difference to the learning experience.

 

 

On 5 May 2004, at 2:14 AM, Alon Marcus wrote:

 

> What works for groups of say one to four foreigners

> observing a Chinese doctor and transmitting only essential elements

> of the case,

>>>> As i said, three morning a week i functioned as the Dr, did the Dx,

>>>> and wrote the Rx. So they were able to translate all the

>>>> information i felt was needed. Its true however, there were only

>>>> about 8 Dr. in that hospital that spoke English, only 4 of them

>>>> well.I would think it would not be expensive to hire English majors

>>>> as translators.

> Alon

>

>

[Guest guest]

In a message dated 5/4/04 11:04:33 AM, alonmarcus writes:

 

 

> Yes, teaching clinics would allow students treat their patients. But

> remember that

> their facilities are much different.

> >>>>When i was in china i studied and worked in a municipal hospital not a

> teaching clinic or hospital. I would think there is much flexibility in

> posibilites

> Alon

>

 

I don't know about today, but when I was doing clinical work in China (1985),

we had our choice of a TCM hospital or the TCM department of a conventional

medicine hospital, both of which sent me patients that had difficulties I asked

to work on. It was in Nanjing, which had large hospitals, though. I went

through the TCM school, which probably made it more expensive. The first month

or

two, I paid for a translator, but then my Chinese caught up and I was able to

do without.

David Molony

 

 

 

[Guest guest]

My experience, in the short times I was there, was not the advanced training but

seeing the context by which all the things I had been studying fell into place.

 

And one thing I found was that I was very well trained in the West and that some

of

the best teachers and doctors are in the West as well. In that I took comfort.

Until

then I had bought into the " secrets of China " idea.

doug

 

 

, " Ai An Meng " <aianmeng@s...>

wrote:

> Doug wrote:

> <<<I agree that a Chinese internship is vital. It's like loving baseball, you

> eventually want to see Yankee Stadium or loving Opera and going to Vienna.>>>

>

> While this may be desireable, its definitely not practical. I don't think the

> average adult student is in a position to just pick up and go overseas for a

> year or two, whether its desireable or not. This might be doable for a single

> student without other obligations, but not so likely for those adults with

> families and other obligations. A requirement like this would prevent many

> very capable students from going any further. I don't see that helping the

> profession at all.

>

> I think the real key is *what* is covered by additional training, and *how*

> it may be structured to advance the acupuncturist's knowledge and ability, not

> per se, where the training is taking place. Hands-on clinical application is

> certainly one area, but practice management, herbal biochemistry, advanced

> theraputics and other areas of training would be equally useful. I don't think

> travel to China is vital for such advanced training to take place. Its simply

> a matter of designing a strong program that better prepares the acupuncture

> student for the practice of Oriental Medicine as a primary practitioner, and

> devising a structure on par with that of Western Medicine programs. If we want

> to be accepted right along with Western Doctors, our training must be equally

> comprehensive, although certainly unique to us.

>

> Kindest Regards,

>

> Andrea

>

>

>

>

[Guest guest]

Depends on who is paying for the treatments... if insurance companies find it

cost

effective it could happen.

doug

 

, " adamhenrymargolis "

<adamhenrymargolis> wrote:

> I'm wondering if it is indeed inconceivable to establish high volume

> specialty CM internships here in the States. I work in the radiation

> oncology department of a hospital in Milwaukee - not by any means a

> city known for widespread interest in .

> Nevertheless, over 65% of new patients express interest in

> incorporating acupuncture and other forms of CAM into their

> treatment. (And many of those who are not interested at first become

> more open to the idea once they start experiencing side effects.) So

> at least within oncology, the patients are there. We would need to

> find and cultivate cooporative institutions and physicians, and CM

> practitioners who are experienced in various specialties. It may not

> be realistic for next year, but what about in 5 years?

>

> Adam Margolis

[Guest guest]

" Upgrading " TCM training to that of Dr.s is not what we want to do.

 

It will make it harder for extraordinary people who would otherwise be

able to take the training and since the cost of school will be so much higher,

making money will have to be the prime reason for the new acupuncture office.

A lot of the training will be western training and which is inherently

poor at the very thing we do well, chronic degenerative disease.

 

What we NEED is more acupuncturists in this country. Not less. We NEED

people concerned with service, not covering the student loan. We NEED high

quality people who would do this profession because of a love of people and

desire to help, not only those who have the finances to take 6 years off from

life

and cover the bill anyway.

 

We do not need to be on par with Dr.s. What possible gain is there in

making it harder to run a clinic where making money has to be the prime

directive or go bankrupt?????

 

This is a bad idea folks. It will eventually take quality people out of

the profession and leave business people. Eventually, business people will

realize they can make more money elsewhere and the profession will fall apart.

 

Lets really think this through. 6 years of school seems like a good idea,

but it will eventually have grave consequences.

 

 

Chris

 

In a message dated 5/5/2004 1:11:24 AM Eastern Daylight Time,

aianmeng writes:

If we want

to be accepted right along with Western Doctors, our training must be equally

comprehensive, although certainly unique to us.

 

Kindest Regards,

 

Andrea