multiple modalities

[Guest guest]

Dave

 

I think you missed my point. In practice I do use multiple modalities.

I was mainly talking about research protocols. Nutrition is not

something I consider separate from herbology, nor are other lifestyle

issues like exercise and relaxation. Those are the cause of illness

and must be part of any form of medicine. However to me, homeopathy

and acupuncture are quite distinct. While there is some overlap

between herbology and either homeopathy or acupuncture (more with the

former, I actually believe), I think that in order to practice either

of these other modalities at its highest level is a fairly separate

study from that of herbology. I do use TCM acupuncture on all my

patients, but I do not use homeopathy as I have never done an

internship in this modality and I consider that unethical. However I

can say unequivocally that in most internal med cases I treat, I think

acupuncture is incidental and could be dispensed with, with no change

in long term results. It is superb for musculo and stress and some

functional disorders, but in int. med., it is mainly good for short

term sx relief and that is why I do it. I know some of you will

immediately think that if I practiced a different form of acupuncture,

I would not find it so incidental in the long term. However I have

worked in teaching clinics my entire career. My colleagues practice

ortho styles, japanese, five element, balance method and TCM. Most of

them are well respected experts in their various styles. And on the

average, not a single one of them has any better long term results from

Acupuncture than a chinese doing barbarian style deep needling TCM. It

doesn't seem to have much to do with the style and everything to do

with the patient. I personally cannot tolerate ortho styles and I know

others who compare getting a japanese treatment to falling asleep at

the opera (i.e. a waste of time).

 

As for projecting confidence based upon personal experience, that is

fine is you actually have experience. But again, seeing five

self-selected hep C patients in five years does not give one the

ethical right to tell a patient that you are an experienced and

successful at treating hep C. Esp. if you did not do lab tests or any

long term followup on those former pt. Sure, there is always a degree

of self-selection in any medical encounter, but the hard sell has not

been part of WM during the era of modern research. This really

distorts things. So unless your patients have largely come to you

through avenues other than hard selling TCM to the public, I do

question the extent of one's actual " experience " . While I do not hard

sell my patients, PCOM does and I know this skews things. I often find

myself trying to mitigate this hard sell. If I actually have enough

experience treating a particular complaint successfully, I will convey

that. If there is research to suggest success,I will say that, too.

If a condition is generally considered effectively treated by TCM alone

in classical and modern books, I will convey that as well. But I will

not pretend, as I know so many do, that TCM has been proven in either

history or research to treat just about everything effectively. For

while this will no doubt have some short term placebo benefit, I

believe in the long term harm is actually done. For chronic internal

illnesses, placebos rarely heal. Relief of symptoms or functional

complaints for a period of time is common, but true spontaneous

remissions are rare and rare enough that they would be a chance event,

not a placebo effect. Patients may thus be deprived of care that would

actually help (which we won't know without research). They will

eventually relapse and join the ranks of satisfied acupuncture patients

who are still sick.

 

 

 

Chinese Herbs

 

 

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