California Acupuncture Board Decreases Herb Portion of Exam

July 26, 2009

Hi Eric,

What you are basically proposing here is creating a Nurse-Practitioner or

Physician Assistant level of education for acupuncturists. Its an interesting

idea, but I don't think that that is the right way to go until we have an entry

level doctorate, and there is a well-defined scope of practice that is

nationally recognized. It doesn't serve the profession to create lesser-skilled

practitioners along with more knowledgable and trained practitioner if people

outside of our profession can't tell the difference. If anything, as

acupuncturists and Chinese herbalists we tend to get more complex and chronic

cases in our practices that require a sophistication in theory and training. I

have taught for many years in several different acupuncture schools. It is

natural to feel that the level of training that we get just out of school is

insufficient to prepare us for jumping into clinical practice. Students just

graduating are overwhelmed with school, boards, their financial obligations, the

logistics of starting a practice... I think, however, that it is important to

keep our educational standards strong and to expose students to a range of

points and theories and herbs. They do call on all of it later in practice. Once

you have practiced a while, then that narrowing of points and medicinals occurs

naturally. As practitioners we find our styles and more simplicity.

-Anne Jeffres

>

> Overall, our training in the U.S. is entirely geared towards becoming a

clinician in private practice. Some of the best clinicians use very few

formulas, very few medicinals, very direct logic, and very simple yet profound

treatments. A practitioner can achieve excellent results with their patients

regardless of whether they have mastered 40 points or 400 points, 40 formulas or

400 formulas. Academic development (scholarship) is a totally separate thing

from clinical practice. The problem is that both aspects are needed in our

community, and currently the " practical clinician " track and the " preparation

for post-graduate study " track are the same.

>

> The schools need to have a program that is effective at training people in the

core herbs, the core points, and the core clinical decisions they need to help

their patients. Many students attend school while working full-time, while

raising children, or while planning for a future home and grounded life. These

people can't just flake off and spend 10 years of their life living like a broke

student studying with a teacher in Asia. Many of these people go on to become

awesome doctors to their patients and pay off their house in the process. They

apply the core principles of Chinese medicine well and they help endless

patients while simultaneously being a good parent or working on some other noble

pursuit. This group accounts for the majority of students, and would be well

suited to a " practical clinician " track of education.

>

> A practical clinician track could focus on herbal medicine, acupuncture, or

both, and it could have classes of different levels of depth and intensity, like

a normal and honor's program. Those who planned to have herbal medicine as a

more background feature of their life could focus on learning 50 formulas and

the basic principles of herbal medicine, without having to suffer through

needless cramming that they neither enjoy nor retain.

>

July 26, 2009

OK, I see your point, but why use Chinese herbs if we may get it as good

with European herbs, but I see your point ...

I cannot speak for others but quite simply I do not think this method is

Chinese medicine.

Correct, and the acupuncture I use is not Chinese medicine as well, but why

must it be Chinese?

I am not denying it doesn't work for you or that your

students don't get great results. That is not the issue. There are plenty of

systems out there that get " great results. " You can talk to any tuning fork

practitioner and they will tell you they get great results -actually almost

everyone I talk to gets " great results. " - but should we teach tuning fork

protocols in school. IMHO, absolutely not. Actually I have found that some

of the best practitioners are the ones who often discuss how not great their

results may be at certain times.

Again, see the point

It is just a matter of what one wants to learn and put their energy into.

Chinese medicine has the history, rigor, and systematic approach that many

of us like.

Agree again

It might be helpful, though, to start writing up your cases and your

thinking behind the choices (people need a system to follow.) If you can

demonstrate over and over that you are making real changes in difficult

diseases, then I think people will be forced to listen. Furthermore it

important to demonstrate when things don't work, why it did not work, and

what one could have been done different.

I have done that, see several articles on the net, for ex

http://syntropi.no/showpage.asp?fileId=342

<http://syntropi.no/showpage.asp?fileId=342 & id=500> & id=500

July 26, 2009

Bob,

it's great to have your perspective, since you've been involved with almost

every facet of

Chinese medicine in America for so long.

With the issue of doing both herbs and acupuncture at the same time,

I think that most practitioners use acupuncture more than herbs for several

reasons:

1. it is *easier *to do a decent acupuncture treatment than to write a

decent formula

a. there are more CEU classes in acupuncture treatment than formula-making

b. there are more books written about acupuncture treatment than in

formula-making

c. acupuncture is more straight-forward (space oriented) than herbology

(time and space oriented).

in other words, formula-making requires a more exact diagnosis to really

get a good result;

in herbology, the patient's history and prognosis is more relevant than in

acupuncture treatment,

where one can give an effective treatment by just seeing what is presented

in front of them.

d. with herbology, you need to be a good pulse-taker (which is arguably

harder to master - more subtle than channel-palpation)

e. acupuncture has less chance of creating side-effects, since herbology

has the potential to be stronger in effects

(herbology creates direct chemical reactions which may interact with other

herbs, foods and drugs)

2. most patients are *more compliant* with coming in and getting an

acupuncture treatment than taking their herbs 2-4 times/ day.

Most patients can do pills and capsules; many have the will-power to do

powders, but only a few can cook their own herbs consistently. This

cultural fact reduces the amount of custom-prescriptions made for the

general patient population.

3. doing formulas correctly requires *clinic-space *

a. there must be shelves and jars and bags and labels and table-space.

b. many practitioners are limited by rental space and the money to rent out

an extra room

(one way to bypass this is to make orders through an herbal company to ship

the herbs directly to the patient)

4. doing formulas correctly requires *time* to think, write and prepare the

formula.

of course, there is a trade-off. If you see 2 patients an hour with

acupuncture, there is little time to create a custom formula.

Although, it can be done, it means that you are running around or are hiring

assistants.

In my clinic, the challenge has been to give patients custom formulas based

on the above constraints.

One way that I've been getting around this is by using Arnaud Versluys'

Shang han za bing lun pulse-conformation-formula

system and fukushin (kampo hara diagnosis) and then using both granules and

pills. I've been checking these with the Omura ring and have found that

one or two out of three formulas that I choose from intellectual means will

almost always test positive. If it doesn't, then I have to rethink my

diagnosis. I think that this is a good balance between using my brain and

the patient's body.

I see applied kinesiology an extension of palpation diagnosis, not the

primary diagnostic by any means.

I do laugh at myself though for doing it.

K

On Sun, Jul 26, 2009 at 7:39 AM, Bob Flaws <bob wrote:

>

> " Not to put down anyone, but maybe these type of people are best suited for

> acupuncture. Just an idea. "

>

> I've been saying for years that acupuncture and " herbs " are two different

> skill sets, and, to be perfectly frank, I also believe acupuncture is easier

> to do effectively. We jammed these two disciplines together, and now most

> L.Ac.s have the legal right to do both (under the ironic heading

> " acupuncture " ). Since we already have that legal right, what do you think

> about now going back and telling students (and graduates) that they can and

> should pick one or the other to " specialize " in? Fifteen years into my own

> practice, I stopped doing acupuncture and only prescribed herbs. I felt I

> had gottn good enough at herbs to make doubling up on therapies an

> unncessary expenditure in time and money for my patients. Interestingly,

> once I stopped doing needles, my herbal medicine got even better. I now was

> absolutely sure what worked and didn't work with another therapy muddying my

> outcomes. therefore, when something didn't work, I knew immediately where

> the problem lay that needed to be fixed (typically by more thought and

> study).

>

> What I'm saying (or perhaps asking), now that the legal right to do either

> or both herbs and acupuncture has been secured (ast least in most states),

> maybe the time is ripe for going back and saying to our profession, " You

> know, you don't have to do both. In fact, if you want to get really good at

> either, pick one and really stick to that. " Do you think this would fly with

> other members of our profession? It's an interesting idea.

>

> If this idea gained traction, our schools could design curricula to teach

> an overview of both modalities as a basis but then go deeply into one or the

> other depending the student's choice. For instance, when I did my B.A., the

> first year we studied a bit of everything under the rubric of liberal arts.

> However, we declared a major in our second year and, from that time onward,

> studied less of everything else and progressively more and more of our

> major. By senior year, most people were only taking classes in their major.

> If such a model were applied to our entry-level schools, graduates would

> then take either the NNCAM acupuncture or herb exam but not necessarily

> both. (Of course, there would alwys be some people who would try to do both

> despite advice to the contrary.)

>

> The problem I see with this is that, based on my interactions with students

> and practitioners, there is a large group who see CM as nothing less than

> the combination of acupuncture and herbs and want to have " the whole

> system. " I think many people would see limiting oneslef to one or the other

> a step backward. Perhaps we've been too good at our own propaganda. This was

> the position of the BOD of the AAAOM at the infamous Chicago ciconvention

> that caused such a rift in our profession.

>

> So, has the pendulum swung far enough to begin swinging back in the

> opposite direction?

>

--

Turtle Island Integrative Health

TCM Review director

CA State Board Prep Courses

www.tcmreview.com

July 26, 2009

Dear All -

It seems to me that teaching skills are lacking throughout the

profession, East and West.

There are cultural complexities that form the landscape for teaching

and learning Chinese medicine. I was speaking with people at the

foreign affairs department about the cross-cultural learning problems.

Their assessment of western learners is that they did not take the

time to discover the answers on their own prior to inquiring with the

teacher.

I believe there are a few factors in Chinese history that conspire to

produce a learning environment that is inconsistent with the western

form of learning. First is the young age which learners begin pursuing

professional-technical education in medicine. At such a tender age,

the songs are learned quickly and the material is memorized. LA holder

of the Beijing Yang family lineage, Yang Tiende, memorized the Shang

Han Lun in his teens. Second is the transmission via family lineage.

Often, the learner was young and was asked to observe until a certain

level of commitment and competency was demonstrated. at that point,

the teacher would give pearls. We want pearls now and we want them

often.

Thirdly, in an attempt to rehabilitate China’s past, Mao began pushing

the development of Chinese medicine through training Western

physicians under senior Chinese physicians. Seventy-nine of China’s

youngest and brightest practitioners - many of whom had planned on

careers as surgeons in the Western paradigm - were in the first class

of Western physicians studying Chinese medicine. Seventy-six completed

the program. In addition, senior Chinese medical practitioners were

forced to come from around the country to teach, leaving high salaries

to receive a government stipend of 200 yuan per month. This must have

been a devastating climate, with unwilling participants. The senior

Chinese medical professors were unprepared to teach in classroom

settings and insisted on an environment with no questions. The Western

medical physicians and the culture at large still had to overcome the

ideological biases against the ‘old’ medicine. This was the ferment

for the teaching methods of the Chinese.

Westerners, however, arrive in schools of Chinese medicine much later

than the Chinese, even with the current admissions trends towards new

college graduates in US schools. This is one piece. I also believe

that we teach pharmacopoeia and formulary in a completely

inappropriate manner for western learners. Westerners learn through

cognitive frameworks rather than rote memorization. For this reason,

context is as important as content and the two should be brought

together.

This is what we do: learners memorize 250-400 medicinals in one year

depending on the program. The next year is spent learning formulas.

The problem is that in the formula course, only about 100-120 of the

medicinals studied in year one are covered. During the internal

medicine sequence, the formulas are reviewed in context and some

additional single herbs are brought for purposes of modification. I

the clinic, only 100-120 agents are purchased by the dispensary,

including the few 'special' agents that senior physicians favor in

practice.

This is crazy making for many. Medical knowledge accrues by

repetition. There is insufficient repetition of the first year

pharmacopoeia knowledge to sustain it. The result is a waste of

precious time. It also harms the psyche and confidence of many

learners, reducing the numbers of aspirants towards deeper medical

knowledge in terms of pharmacopoeia and formulary. For these reasons,

Chinese medicinals present a difficult body of knowledge to grasp and

it takes a good deal of commitment to practice.

Warmly,

Will

--

William R. Morris, PhD, DAOM, LAc

http://pulsediagnosis.com/

http://www.aoma.edu/

http://taaom.org/

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July 26, 2009

Hello All,

Very interesting dicussion about the practice of Acupuncture and the

dispensing/prescribing of

herbal medicines. Currently I am completing my Doctorate in Ayurvedic Medicine,

which has

it's own pharmacopia of herbs and formulae. A great deal of my participation in

the Ayurvedic

program has left me longing for my TCM education, and many things have been a

source of

relief to be branching out.

I agree with , one of my most esteemed teachers, regarding the

teaching of TCM here

in the West. Z'ev is correct in saying that there are certain complex trains of

thought that are

uniquely TCM that many Western minds are not grasping. Perhaps this stems from

the programs being too

abbreviated, perhaps it is the completely different cultural roots, I don't

know. Unfortunately, many students are

concerned with covering all bases, acupuncture, herbs and whatever other

techniques that may

set them apart in order to make a living and be " successful " in their chosen

career. It is quite

contrary to the Eastern mentality.

It would be very important to deepen our knowledge of EITHER acupuncture

or herbs, since our educations require we learn so much superfluous information

to conform to state

standards, that we lose a lot of deeper knowledge unless we seek it AFTER

graduation.

So, I whole-heartedly agree that students should minimally have a focus on

either herbs

or acupunture. There is immense knowledge and learning that goes into each of

them separately

let alone together!!!

When I was in China, that is precisely how most doctors practiced. There were

the herbal docs (who

often did do some acupuncture, but were not " known " for that) and there were the

docs that

practiced the acupuncture and hands-on methods. Tui na was also practiced

separately.

Another person here at CHA had mentioned that the laws are part of the problem,

which I also

agree with. Our herbal medicines are easy to come by, and every Whole Foods or

health food store

has people there telling comsumers what to ingest in the name of health. This is

CRAZY!!!

The government takes Ma huang and typtophan off the shelves and out of our

practices when they should not have

been so freely available to the public to begin with... We face too many people

with no or too

little training " practicing " herbal MEDICINE!!!! In the Ayurvedic community, we

are facing huge

issues as well... there is no formal " license " so we have enormous issues

regarding people practicing

this form of medicine without any training... Not that we need over-regulation,

but APPROPRIATE

regulation is certainly needed.

I suppose I am not chiming in anything new. My hats off to practitioners and

brilliant professors like

who light the way with their knowledge... Unfortunately, schools

are also BUSINESSES so

there is not enough of a weeding out process in who really is there for the

correct motivation. I, for one,

am grateful for the few excellent teachers I had that encouraged me to continue

learning, and

to arrive at the Doctoral level in the hope of improving the field as well as

peoples' health. Thanks for

all of your input... and for the very interesting discussion.

Sincerely,

Stephanie Schneider LAc, MTOM, AyD (in process)

July 26, 2009

In Psychology, I have noticed that many people who aren't very good at what

they do, compensate for this by memorizing long lists of published studies

and whatnot. It's like a compensatory facade.

July 27, 2009

Will, I would add that there were no textbooks at this time either and were only

invented over a very short time to meet their immediate needs. I don't know but

I would hazard a guess that for acupuncture, the books haven't progressed much.

Someone tell me different. (I happen to believe in the " herbs are easy,

acupuncture is hard " statement.)

To Will and all:

We do have a dilemma in the herbs... On the one hand more study is needed yet

time and the structure of our classes falls short as Will has pointed out. I

have heard enough that I'm not sure this structure works all that well in China

either.

I have been advocating for an " introduction to Formulas " after individual herbs

and before Formulas as a stop-gap measure. We now have two marvelous tools in

the form of books from Huang Huang, 50 Medicinals (PMPH) and 10 Formulas

(Eastland) that can slide students into the complexity of Formulas and

Strategies. Whether we want students to be mandated to go further into herbs is

an interesting question.

I once worked in an herb store that did most of their business to what I called

" cowboy herbalists " , absolutely devoted and fanatical (in a good way) amateur

herbalists. From them I saw that there was no way, nor should there be, a ban on

individuals buying and using herbs. (Prescribing herbs to others is another

story.)

So do we dare limit the amount of herb formula knowledge give to our students?

Jason (I believe) was absolutely correct in that many of our patients have very

complex and chronic cases. Does this mean we need more formulas or just a better

grasp of fewer of them?

hmmm....

Doug

, William Morris <wmorris33 wrote:

>...................

>

> Thirdly, in an attempt to rehabilitate China's past, Mao began pushing

> the development of Chinese medicine through training Western

> physicians under senior Chinese physicians. Seventy-nine of China's

> youngest and brightest practitioners - many of whom had planned on

> careers as surgeons in the Western paradigm - were in the first class

> of Western physicians studying Chinese medicine. Seventy-six completed

> the program. In addition, senior Chinese medical practitioners were

> forced to come from around the country to teach, leaving high salaries

> to receive a government stipend of 200 yuan per month. This must have

> been a devastating climate, with unwilling participants. The senior

> Chinese medical professors were unprepared to teach in classroom

> settings and insisted on an environment with no questions. The Western

> medical physicians and the culture at large still had to overcome the

> ideological biases against the `old' medicine. This was the ferment

> for the teaching methods of the Chinese.

> .....................

> This is what we do: learners memorize 250-400 medicinals in one year

> depending on the program. The next year is spent learning formulas.

> The problem is that in the formula course, only about 100-120 of the

> medicinals studied in year one are covered. During the internal

> medicine sequence, the formulas are reviewed in context and some

> additional single herbs are brought for purposes of modification. I

> the clinic, only 100-120 agents are purchased by the dispensary,

> including the few 'special' agents that senior physicians favor in

> practice.

>

> This is crazy making for many. Medical knowledge accrues by

> repetition. There is insufficient repetition of the first year

> pharmacopoeia knowledge to sustain it. The result is a waste of

> precious time. It also harms the psyche and confidence of many

> learners, reducing the numbers of aspirants towards deeper medical

> knowledge in terms of pharmacopoeia and formulary. For these reasons,

> Chinese medicinals present a difficult body of knowledge to grasp and

> it takes a good deal of commitment to practice.

>

> Warmly,

>

> Will

>

July 27, 2009

, " taoacu " <ajeffres wrote:

>

> Hi Eric,

> What you are basically proposing here is creating a Nurse-Practitioner or

Physician Assistant level of education for acupuncturists. Its an interesting

idea, but I don't think that that is the right way to go until we have an entry

level doctorate, and there is a well-defined scope of practice that is

nationally recognized. It doesn't serve the profession to create lesser-skilled

practitioners along with more knowledgable and trained practitioner if people

outside of our profession can't tell the difference.

I agree with you. I am not one to advocate any changes to the delicate balance

of the law, and I certainly only want to see the educational standards increase

rather than decrease. If anything, I would make a minute adjustment only. For

a school like PCOM, which tries to carve out a niche as a leader and has enough

students per cohort to have two sections of each class, it would be easy to just

make one section an honors class and the other section a normal class. The

syllabus could be the same, but the students that mostly want to focus on

acupuncture could have an easier herbs class, while the students that want to

focus on herbs could have an honors class.

The main reason that I got on the topic of separating the students into a normal

track and an honor's track is not because I want to make the normal track easier

than it already is. Rather, I'd like to add an honors track, basically just

have one of the two sections be more advanced and only occupied by interested

students. I proposed this idea because Bob asked me where we could find

qualified teachers... and I think the way to keep good teachers passionate is to

give them a class of students that truly want to learn.

Eric Brand

July 27, 2009

It is my experience, the issue of patient compliance with raw herbs is the

practitioners issue the majority of the time. Even as a student I remember

other students saying none of the patients will take raw herbs, however both

in my private practice and as a student, almost all of my patients take raw

herbs. It is all how the practitioner approaches this issue with the

patients, as well as one's confidence in the method. Furthermore, when one

can deliver results quickly with raw herbs the patient is definitely

inclined to keep taking them.

-Jason

On Behalf Of

Sunday, July 26, 2009 10:06 AM

Re: Re: California Acupuncture Board Decreases Herb Portion

of Exam

2. most patients are *more compliant* with coming in and getting an

acupuncture treatment than taking their herbs 2-4 times/ day.

Most patients can do pills and capsules; many have the will-power to do

powders, but only a few can cook their own herbs consistently. This

cultural fact reduces the amount of custom-prescriptions made for the

general patient population.

July 27, 2009

Stephanie,

Thank you for your kind post, although I don't know if I deserve

such kudos. I just wanted to say that I don't support separation of

herbal medicine and acupuncture in the CM programs at this point in

time, it would be weakening to the profession. Also, herbal medicine

is still not established in the West at this point, and it would be

harder to make a living without it. Having said that, I agree that it

is difficult to focus on both acupuncture and herbal medicine studies

at the same time, and perhaps at different points of one's education

emphasis can be put on one or the other.

Glad to hear of your continuing studies in Ayurvedic medicine.

Another noble, kingly/queenly medical system.

On Jul 26, 2009, at 12:30 PM, Stephanie Schneider wrote:

> n the West. Z'ev is correct in saying that there are certain complex

> trains of thought that are

> uniquely TCM that many Western minds are not grasping. Perhaps this

> stems from the programs being too

> abbreviated, perhaps it is the completely different cultural roots,

> I don't know. Unfortunately, many students are

> concerned with covering all bases, acupuncture, herbs and whatever

> other techniques that may

> set them apart in order to make a living and be " successful " in

> their chosen career. It is quite

> contrary to the Eastern mentality.

> It would be very important to deepen our knowledge of EITHER

> acupuncture

> or herbs, since our educations require we learn so much superfluous

> information to conform to state

> standards, that we lose a lot of deeper knowledge unless we seek it

> AFTER graduation.

> So, I whole-heartedly agree that students should minimally have a

> focus on either herbs

> or acupunture. There is immense knowledge and learning that goes

> into each of them separately

> let alone together!!!

Chair, Department of Herbal Medicine

Pacific College of Oriental Medicine

San Diego, Ca. 92122

July 27, 2009

Interestingly, in China one focuses on one or the other, but is used for both at

all times. Why don't we have people trained to do both well for an entry level

doctorate, and focus on one? Specialization just ends up costing the patient

more, except in cases where one is doing one modality at a time like in a

hospital situation, as in China. Unfortunately, we are a bit of a distance from

that ideal here.

Acupuncture can be more time intensive than herbal medicine, too.

DAvid Molony

On Jul 26, 2009, at 10:39:32 AM, " Bob Flaws " <bob wrote:

The problem I see with this is that, based on my interactions with students and

practitioners, there is a large group who see CM as nothing less than the

combination of acupuncture and herbs and want to have " the whole system. " I

think many people would see limiting oneslef to one or the other a step

backward. Perhaps we've been too good at our own propaganda.

July 27, 2009

Will,

Your post is spot on, for now I'd like to focus on this section

from your post below. I think it is a major issue that graduate

practitioners do not know how to look up how to treat conditions on

their own, whether in existing textbooks, online, or in Chinese source

materials. This is why medical Chinese language must be taught from

the very beginning of training. I am amazed at some of the questions

about treating conditions I see on e-mail groups, although it is less

of a problem on CHA than in other places.

I think this is a very constructive discussion indeed. It shows

the profession has reached a new stage of maturity where we can self-

reflect and move forward.

On Jul 26, 2009, at 11:47 AM, William Morris wrote:

>

> There are cultural complexities that form the landscape for teaching

> and learning Chinese medicine. I was speaking with people at the

> foreign affairs department about the cross-cultural learning problems.

> Their assessment of western learners is that they did not take the

> time to discover the answers on their own prior to inquiring with the

> teacher.

Chair, Department of Herbal Medicine

Pacific College of Oriental Medicine

San Diego, Ca. 92122

July 27, 2009

Eric,

I think that this idea from yout last post:

" Rather, I'd like to add an honors track, basically just have one of the two

sections be more advanced and only occupied by interested students. "

is right on. This seems to get to the major issue.. which is that there is

a huge gap between students in the same class.

Not everyone is a blank slate, bringing their own life experiences to the

table.

Even by the time they're 16, there are AP classes.

Another idea is having independent study available for the " progressed

students " ,

in order to reserve resources for the school.

K

On Mon, Jul 27, 2009 at 2:49 AM, Eric Brand <smilinglotus wrote:

>

> --- In

<%40>,

> " taoacu " <ajeffres wrote:

> >

> > Hi Eric,

> > What you are basically proposing here is creating a Nurse-Practitioner or

> Physician Assistant level of education for acupuncturists. Its an

> interesting idea, but I don't think that that is the right way to go until

> we have an entry level doctorate, and there is a well-defined scope of

> practice that is nationally recognized. It doesn't serve the profession to

> create lesser-skilled practitioners along with more knowledgable and trained

> practitioner if people outside of our profession can't tell the difference.

>

> I agree with you. I am not one to advocate any changes to the delicate

> balance of the law, and I certainly only want to see the educational

> standards increase rather than decrease. If anything, I would make a minute

> adjustment only. For a school like PCOM, which tries to carve out a niche as

> a leader and has enough students per cohort to have two sections of each

> class, it would be easy to just make one section an honors class and the

> other section a normal class. The syllabus could be the same, but the

> students that mostly want to focus on acupuncture could have an easier herbs

> class, while the students that want to focus on herbs could have an honors

> class.

>

> The main reason that I got on the topic of separating the students into a

> normal track and an honor's track is not because I want to make the normal

> track easier than it already is. Rather, I'd like to add an honors track,

> basically just have one of the two sections be more advanced and only

> occupied by interested students. I proposed this idea because Bob asked me

> where we could find qualified teachers... and I think the way to keep good

> teachers passionate is to give them a class of students that truly want to

> learn.

>

> Eric Brand

>

--

Turtle Island Integrative Health

TCM Review director

CA State Board Prep Courses

www.tcmreview.com

July 27, 2009

Jason,

There are many factors about compliance with patients preparing dried herbs.

clientele (how much money they earn, how much time they have to cook herbs

correctly,

how consistent they are in other activities)

I ask if they even eat 3 meals a day and if they cook for themselves.

If they do, then the probability is that they will be consistent with

cooking dried herbs;

if not, I have seen that they " forget " more often then not.

It depends on where you live as well....

people in Boulder are a different breed, I know because I lived there for 5

years.

My friend in Marin (very affluent area) has patients who will take dried

herbs 3x/day because they have nothing else to do,

except go to the spa and Whole Foods. (not to say there's anything wrong

with that).

Most of my clientele work 40 plus hours / week and take time off from work

to get treatments.

In the past, I tried to get them to take dried herbs, so they could cook

them in the morning or in a crock pot

and then carry them to work in a thermos to drink for the next 10 hours,

since you can't cook while you're at work.

In the long run, it was a no-brainer. Every work-space has hot water

available for mixing in concentrated powders.

For me, the most important thing is that they get the herbs inside of them

as consistently as possible.

I worked at a herb company for 7 years and saw what practitioners and

patients do on a daily basis.

Most people are going to powders for just these reasons. People are getting

great results from powders.

A good question is : is the patient cooking the dried herbs more medically

effective than taking powders?

I really don't think so. The reason is that patients don't often cook the

medicinals as effectively as the experts

who make the powders. We can argue about 'good karma in doing things for

yourself'

or getting the Qi from making your own medicine....

but, under and over cooking, losing essential oils in the process and not

squeezing out the juices from the roots and fruits

are issues about patients doing their own herbal preparation.

Also, because of the above issues, dosing becomes less specific when the

patient cooks their own herbs.

Of course, everyone's different and I love dried herbs, especially the idea

of having them on the shelves and even better,

growing them ourselves. The Chinese Herbal Consortium is doing great things

here in the states. It's an enormously

difficult and non-profitable job... farming on small scale, but it's a great

service to our profession. For those in Northern CA,

you can visit Peggy Schafer's farm. Are there Chinese herb farms in

Colorado? The high elevation would be a benefit for certain herbs. All in

all, the consortium (from around the country) is growing most of the herbs

in our pharmacopeia.

K

On Mon, Jul 27, 2009 at 6:39 AM, <

> wrote:

>

> It is my experience, the issue of patient compliance with raw herbs is the

> practitioners issue the majority of the time. Even as a student I remember

> other students saying none of the patients will take raw herbs, however

> both

> in my private practice and as a student, almost all of my patients take raw

> herbs. It is all how the practitioner approaches this issue with the

> patients, as well as one's confidence in the method. Furthermore, when one

> can deliver results quickly with raw herbs the patient is definitely

> inclined to keep taking them.

>

> -Jason

>

> <%40>

>

[ <%40>\

]

> On Behalf Of

> Sunday, July 26, 2009 10:06 AM

> <%40>

> Re: Re: California Acupuncture Board Decreases Herb Portion

> of Exam

>

> 2. most patients are *more compliant* with coming in and getting an

> acupuncture treatment than taking their herbs 2-4 times/ day.

> Most patients can do pills and capsules; many have the will-power to do

> powders, but only a few can cook their own herbs consistently. This

> cultural fact reduces the amount of custom-prescriptions made for the

> general patient population.

>

July 27, 2009

John,

Yes there are many factors. However I do see people from all over, not just

Boulder. Many are just average mid-west folk that drive (or fly) 1-2 hours

to see me. Just 3 weeks ago, I saw someone that had not prepared a meal by

themselves in years. Now they are taking / cooking herbs and feeling better

(after 1 week). Granulars, IMO, would not have gotten the quick results. Now

going on three weeks, she is happy to keep cooking. I see this over and

over. I am confident I can get patients to take bulk herbs in any city.

Obviously if you present a patient with 2 options, and you say 1 is easy and

1 is hard, but both are equally effective, what do you think they will say?

But in my clinical experience, as well as all practitioners in my office

such as veterans like Chip Chace, bulk herbs are more effective than

granulars. We have both.

However if you find something that works great, but I have a very hard time

believing that patients won't do it. Actually most practitioners here in

Boulder tell me the same thing that you do, patients just don't have time.

So it is clear that it is the practitioners issue, not the patients, if I

can get them to do it. For the record, I went to school in San Diego.

-Jason

On Behalf Of

Monday, July 27, 2009 10:25 AM

Re: Re: California Acupuncture Board Decreases Herb Portion

of Exam

Jason,

There are many factors about compliance with patients preparing dried herbs.

clientele (how much money they earn, how much time they have to cook herbs

correctly,

how consistent they are in other activities)

I ask if they even eat 3 meals a day and if they cook for themselves.

If they do, then the probability is that they will be consistent with

cooking dried herbs;

if not, I have seen that they " forget " more often then not.

It depends on where you live as well....

people in Boulder are a different breed, I know because I lived there for 5

years.

My friend in Marin (very affluent area) has patients who will take dried

herbs 3x/day because they have nothing else to do,

except go to the spa and Whole Foods. (not to say there's anything wrong

with that).

Most of my clientele work 40 plus hours / week and take time off from work

to get treatments.

In the past, I tried to get them to take dried herbs, so they could cook

them in the morning or in a crock pot

and then carry them to work in a thermos to drink for the next 10 hours,

since you can't cook while you're at work.

In the long run, it was a no-brainer. Every work-space has hot water

available for mixing in concentrated powders.

For me, the most important thing is that they get the herbs inside of them

as consistently as possible.

I worked at a herb company for 7 years and saw what practitioners and

patients do on a daily basis.

Most people are going to powders for just these reasons. People are getting

great results from powders.

A good question is : is the patient cooking the dried herbs more medically

effective than taking powders?

I really don't think so. The reason is that patients don't often cook the

medicinals as effectively as the experts

who make the powders. We can argue about 'good karma in doing things for

yourself'

or getting the Qi from making your own medicine....

but, under and over cooking, losing essential oils in the process and not

squeezing out the juices from the roots and fruits

are issues about patients doing their own herbal preparation.

Also, because of the above issues, dosing becomes less specific when the

patient cooks their own herbs.

Of course, everyone's different and I love dried herbs, especially the idea

of having them on the shelves and even better,

growing them ourselves. The Chinese Herbal Consortium is doing great things

here in the states. It's an enormously

difficult and non-profitable job... farming on small scale, but it's a great

service to our profession. For those in Northern CA,

you can visit Peggy Schafer's farm. Are there Chinese herb farms in

Colorado? The high elevation would be a benefit for certain herbs. All in

all, the consortium (from around the country) is growing most of the herbs

in our pharmacopeia.

K

8.5.392 / Virus Database: 270.13.32/2266 - Release 07/27/09 05:58:00

July 27, 2009

On a quick follow-up note - In very busy patients (when appropriate) I will

graduate them to granulars after they are stabilized and symptoms are

reduced or eliminated. This is one reason I am clear on the effect of

granulars versus bulk. It is amazing how many people will demand back the

bulk herbs. Some though, have no problems with the transition.

-Jason

On Behalf Of

Monday, July 27, 2009 11:43 AM

RE: Re: California Acupuncture Board Decreases Herb Portion