was patient load, now software for speedier diagnosis

[Guest guest]

Re: patient load

 

> Laura wrote:

> > am definitely struggling with this issue. . . The amount

> of money that I get in exchange for the herbs just doesn't

> seem worth all the work involved. Therefore I am only

> prescribing herbs for people if I've tried acupuncture and

> its not getting the results that I want

 

>

>That's so unfortunate, but I truly understand. That's why

I am so enthusiastic about the

>potential for software to facilitate the study and clinical

application of herbs. There are

>already programs out there that can speed up individual

prescribing many times by giving

>you more rapid access to possible solutions to any case.

Proper use of these programs

>can enable rapid multipattern prescribing. I have recently

been approved for a CEU class

>on the use of computers in this process. It will be given

at PCOM in the fall. I am also

>developing my own software to aid the formulation process.

Keep you posted.

 

I think such software would be great for us herb novices who

want to provide good care and stay in business. I have read

about Roger Wicke's software online which includes a whole

TCM self-study course. It looks excellent but the price tag

is holding me back just a bit (about $600). (How many 100's

have I spent on books already this year?) Are there other

programs? Is the CEU class you'll be giving something that

would be appropriate for 'distance learning' format? Yes,

please keep us posted re: your own software. If I'm still in

practice, I'll be very interested.

 

Marian

 

 

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[Guest guest]

, " Marian Blum " <marianb@r...> wrote:

 

>

> I think such software would be great for us herb novices who

> want to provide good care and stay in business. I have read

> about Roger Wicke's software online which includes a whole

> TCM self-study course. It looks excellent but the price tag

> is holding me back just a bit (about $600).

 

 

actually the self study course and pulse simulator and study advisor games plus

a partial

formula database are only $350

 

Are there other

> programs?

 

Acuvision is one I like. It's database includes wiseman and bensky sources. You

should

order a free demo from archibel.com. For databases that include formulas, both

Roger's

program and the acuvsion are still the only ones I have seen that are really set

up to

facilitate complex diagnosis by allowing numerous case parameters to be entered

into the

search engine. Shen professional does this for acupuncture only (at

www.shen.de). None

of the other databases and software I have reviewed allow complex boolean type

searches.

Without such a search engine, software is only a step above a book. But full

boolean

searching allows the ability to access a huge range of information to compare

and contrast

in moments. One still has to understand the information to make use of it.

Such software

merely simplifies the searching process. And while Jason may be right that

people should

remember more and look up less, the human brain is limited in this capacity. And

today's

px has to hold far more data in their heads (western med, legal, insurance,

business, etc.)

I would also argue that while such sheer recall is the ideal of some, that it

was probably

rare in ancient china to excel in this area just as it is today. In ancient

times, doctors

would have come from a broad cross section of the population just as modern

american

px do. But in China, most folks were forced into their professions based upon

aptitude

and learning styles, particularly the ability to memorize. The fact that this

skill seems to

dominate in the minds of modern chinese practitioners may be an artifact of

modern

chinese social engineering and pragmatism more than a reflection of some innate

chinese

superiority in this area.

 

 

Is the CEU class you'll be giving something that

> would be appropriate for 'distance learning' format?

 

Possibly, but I need to do it live a few times and then make DVD's first.

 

Yes,

> please keep us posted re: your own software. If I'm still in

> practice,

 

 

still in practice??

 

[Guest guest]

And while Jason may be right that people should

remember more and look up less,

>>>Just let him age a little

alon

 

 

[Guest guest]

actually the self study course and pulse simulator and study advisor games plus

a partial

formula database are only $350

>>>What extra do you get in the 600 version

alon

 

 

[Guest guest]

, " "

 

wrote:

 

And while Jason may be right that people should

 

> remember more and look up less, the human brain is limited in this

 

capacity. And today's

 

> px has to hold far more data in their heads (western med, legal,

 

insurance, business, etc.)

 

> I would also argue that while such sheer recall is the ideal of

 

some, that it was probably

 

> rare in ancient china to excel in this area just as it is today.

 

In ancient times, doctors

 

> would have come from a broad cross section of the population just

 

as modern american

 

> px do. But in China, most folks were forced into their professions

 

based upon aptitude

 

> and learning styles, particularly the ability to memorize. The

 

fact that this skill seems to

 

> dominate in the minds of modern chinese practitioners may be an

 

artifact of modern

 

> chinese social engineering and pragmatism more than a reflection of

 

some innate chinese

 

> superiority in this area.

 

 

 

I think the other point here is that keeping all the data in one's

head in not necessarily the desired result, but more importantly the

process of learning that goes along with memorizing while in school.

 

I propose that it is the process that teaches one to think CM. For

example, I often will look stuff up that I had forgotten, but when

writing the formulas the inherit structures that are engrained from

memorizing can allow one to pick the correct herb / combinations/

dose... If one is just content with matching a 1 disease / 1 pattern

to a textbook formula then I say don't bother about memorizing

ingredients in formulas etc, but if one strives for writing

individual formulas then it seems almost mandatory.

 

 

 

_jason

[Guest guest]

I am not saying that one should keep everything in one's head. I would love

to every book I owned in a computer and be able to search it. But as

previously pointed out, one must learn how to 'think CM' - the question is

how does this happen. I think it is just a byproduct that the Chinese can

recite all that they can from this process

 

>>>As always the question is what style results in best outcome clinically as

well as time efficiency. I tend to believe that one is always better off

learning to problem solve than memorize. i do not believe memorization has

anything to do with thinking CM.

Alon

 

 

[Guest guest]

, " alon marcus " <alonmarcus@w...>

wrote:

> actually the self study course and pulse simulator and study advisor games

plus a partial

> formula database are only $350

> >>>What extra do you get in the 600 version

> alon

 

 

A complete herbs, formulas and syndromes database that is fully searchable with

unlimited parameters, fields and boolean variables. I have suggested to Roger

that some

people might want just this latter module and not the course or pulse simulator.

What do

you think?

 

[Guest guest]

, " " <@h...>

wrote:

 

>

> I propose that it is the process that teaches one to think CM. For example,

> I often will look stuff up that I had forgotten, but when writing the

> formulas the inherit structures that are engrained from memorizing can allow

> one to pick the correct herb / combinations/ dose... If one is just content

> with matching a 1 disease / 1 pattern to a textbook formula then I say don't

> bother about memorizing ingredients in formulas etc, but if one strives for

> writing individual formulas then it seems almost mandatory.

 

 

I agree with most of us. the open question is which process leads to better

long term

retention and thus achieves your goal. I believe for most people the answer is

classes

centered around cases and problems to stimulate learning and memory. Not a

substitute

for memory, but a way to learn. For those who are very self-motivated and have

above-

average inborn memory abilities, the classroom is generally of no interest at

all. In my

CHIM 1 class, we spend all semester working on the crafting of multipattern zang

fu

formulas or identifying pathomechanisms that allows us to choose SHL formulas.

The

class is all about NOT " matching 1 disease / 1 pattern to a textbook formula " .

It is about

comparing and contrasting a number of formulas and herbs to make up one for your

patient. I would lay odds you did a lot of this on your own while in school. I

know you

maintained a phamacy and filled rx for classmates as well as treating yourself.

I did the

same thing. Now you probably know a lot of the stuff you used to have to look

up at this

earlier stage.

 

So the question again comes back to whether you or most people are best served

by

memorizing lists of things out of context or learning things in context through

cases and

problems. I think the same tests should be used to determine what has been

learned. At

PCOM, changes to case based (not PBL, though) have not altered COMP grades, but

subjectively most of tje clinical supervisors believe there have been noticeable

changes in

the way students think. The fact is that before we made these changes, the

memorization

was still pretty poor for herbs and formulas as was the ability to prescribe.

Now at least

students know how to use their resources to get the ball rolling and withthe dat

in front of

them, most are able to prescribe. The process, as you mentioned, will teach

them the data

over. Perhaps just a different process than you had in mind. Sure it would be

better to

have more in your head already by the time you reached internship, but my goal

is create a

structure that will continue to facilitate the goal over time, even after the

students leave

me. This is a far better outcome than a profession of dilletantes prescribing

the same ten

patent meds for everything or muscle-testing their patients. And arguably, if

PBL was

implemented from day one at PCOM, far more students would " have more in their

heads "

by the time internship started.

 

[Guest guest]

, " " <@h...>

wrote:

>

> I am not saying that one should keep everything in one's head. I would love

> to every book I owned in a computer and be able to search it. But as

> previously pointed out, one must learn how to 'think CM' - the question is

> how does this happen. I think it is just a byproduct that the Chinese can

> recite all that they can from this process...

 

 

If you are saying that having all the data in place is sufficient for

understanding. Do you

need to remember every herb in gui pi tang to recall the basic dynamics of the

rx, for

example. I was more likely to remember the latter years ago and if I have to

crack a book

to fill in the final details, so what? My memory of dynamics typically lead me

to the right

place. And over time, that is how I learned the ingredients. No amount of

reading lists

would have achieved that goal and it would have displaced all the time I spent

coming to

an understanding of TCM.

 

[Guest guest]

A complete herbs, formulas and syndromes database that is fully searchable with

unlimited parameters, fields and boolean variables. I have suggested to Roger

that some

people might want just this latter module and not the course or pulse simulator.

What do

you think?

>>>>>I think its a good idea for practitioners

alon

 

 

[Guest guest]

, " "

wrote:

> , " "

<@h...>

> wrote:

> >

> > I am not saying that one should keep everything in one's head. I

would love

> > to every book I owned in a computer and be able to search it.

But as

> > previously pointed out, one must learn how to 'think CM' - the

question is

> > how does this happen. I think it is just a byproduct that the

Chinese can

> > recite all that they can from this process...

>

>

> If you are saying that having all the data in place is sufficient

for understanding. Do you

> need to remember every herb in gui pi tang to recall the basic

dynamics of the rx, for

> example. I was more likely to remember the latter years ago and if

I have to crack a book

> to fill in the final details, so what? My memory of dynamics

typically lead me to the right

> place. And over time, that is how I learned the ingredients. No

amount of reading lists

> would have achieved that goal and it would have displaced all the

time I spent coming to

> an understanding of TCM.

 

Yes I think what you describe in this email and the previous

dovetails into what I consider essential step for understanding TCM.

I never JUST memorized lists, but always pathodynamics, and always

with the lists. Real cases and case studies etc always help solidify

the essence of the formula. I think just outright memorizing lists

is silly, and I think what you describe is what I did on my own,

maybe it would have been totally different if the classes (when I

went to PCOM) were problem /cased based... I had to do everything on

my own... oh well...

 

-

 

>

 

[Guest guest]

On Aug 30, 2004, at 2:55 PM, wrote:

 

> I never JUST memorized lists, but always pathodynamics, and always

> with the lists.

 

This was my focus as well. It has served me well, both on the state

boards and in practice.

 

--

 

Pain is inevitable, suffering is optional.

-Adlai Stevenson