Interested in complimentary and alternative medicine

[medhearter]

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Hello,

Share thoughts.

 

[medhearter]

also, any ideas on CAM-friendly and CAM-promoting institutions? perhaps schools that conduct research in CAM and can hence indicate its translation it into regular clinical practice

My interest lies in practicing CAM in conjunction with the traditional allopathy.

Specialty interests are broad, but include oncology and neurology.

 

[Gryhu]

GW has a center for integrative medicine. Theres a track program that specializes in integrative medicine in conjunction with the core curriculum. More info here.

 

[Perrotfish]

also, any ideas on CAM-friendly and CAM-promoting institutions? perhaps schools that conduct research in CAM and can hence indicate its translation it into regular clinical practice

My interest lies in practicing CAM in conjunction with the traditional allopathy.

Specialty interests are broad, but include oncology and neurology.

On of the most difficult things we do as physicians is to tell a patient (or worse, their loved ones) that there is nothing we can do. Neurology and Oncology are both examples of fields where we are often forced to admit that we have no therapy to offer other than some modestly effective pain relief, or that the therapy that we have available is horribly flawed and barely effective. CAM is an easy out: we can offer the illusion that we are still helping, the patient can keep pretending the future is brighter and that we are going to save the day, and we even get paid extra for it. However when the end comes, and the patient never had a chance to come to terms with their mortality, or to say goodbye... I think that what's best for our patients is for the physicians to be physicians, and to leave the CAM for someone else to deal with.

 

[medhearter]

thank you for the replies

found this after a forum search actually:

http://imconsortium.org/opportunities/trainingopportunities/home.html

should be useful

perrotfish, that is why i'm interested in institutions that are actively conducting research in CAM. i agree with you, for CAM to be received well in medicine there has to be evidence.

in terms of neurology and oncology. telling a patient that nothing can be done should not be the only option. as a physician, if you have the opportunity to expand the horizons by which patients can receive evidence-based treatments, then you should.

 

[Hernandez]

.
in terms of neurology and oncology. telling a patient that nothing can be done should not be the only option. as a physician, if you have the opportunity to expand the horizons by which patients can receive evidence-based treatments, then you should.

🙄 how you a dress impending death and disease processes you can't fix deserves honesty, not bull**** false hope. people with your attitude is why I end up telling people that, yes, grandma really is going to die, eve if I get her through what ever natural process that landed her in my MICU....

 

[medhearter]

🙄 how you a dress impending death and disease processes you can't fix deserves honesty, not bull**** false hope. people with your attitude is why I end up telling people that, yes, grandma really is going to die, eve if I get her through what ever natural process that landed her in my MICU....

didn't say that

there are numerous examples of generally well patients who develop a condition for which nothing is indicated medically, or only symptomatic treatment can be provided, or treatments available in medicine today create other medical problems. if we can help it, we can try to offer more options to the patient.

eastern medicine, or "CAM" as it may overlap with, may offer effective treatments for such conditions. the point is to become aware and to appropriately evaluate these treatments for the purpose of being able to incorporate them into medicine as it is and make it more effective at treating patient's overall health concerns.

hence the need for appropriate study into what is the largely misunderstood integrative medicine, and an actual evaluation of literature as it grows.

 

[Hernandez]

didn't say that

there are numerous other examples of generally well patients who develop a condition for which nothing is indicated medically. in my mind, that isn't an acceptable answer.

eastern medicine, or "CAM" as it may overlap with, may offer treatments for such conditions. the point is to become aware and to appropriately evaluate these treatments for the purpose of being able to incorporate them into medicine as it is and make it better and more effective at treating patient's health concerns. in my mind saying "nothing is indicated as therapy" is being lazy. and to say "let the CAM people take care of it", is also being lazy, giving up on your patient, and doing away with an opportunity to do something more worthwhile.

so sending them out for unscientific, false hope or worse giving them medication that isn't indicated is better than being honest that in this day and age we can't treat their disease? these situations are where phase 1-3 trials are needed, and why we should be wasting money on CAM, when we have real science looking into the how and why's and looking for safe, reliable methods of treatment.

 

[medhearter]

so sending them out for unscientific, false hope or worse giving them medication that isn't indicated is better than being honest that in this day and age we can't treat their disease? these situations are where phase 1-3 trials are needed, and why we should be wasting money on CAM, when we have real science looking into the how and why's and looking for safe, reliable methods of treatment.

again didnt say that.
i'm stressing evidence-based integrative medicine
and i'm stressing it for things we don't have real science nor real methods of treatment.

 

[Hernandez]

again didnt say that.
i'm stressing evidence-based integrative medicine
and i'm stressing it for things we don't have real science nor real methods of treatment.

at you're arguing for is non-sequatoric in your approach, you want to farm out people we have no treatment for to these people whom to date and despite research have shown little to no in the way of scietifically vialbe treatments for diseases? and then reserach their methods to show validity? no thank you. you'll just feed into the masses that think we're hiding the cure for cancer, or are keeping people sick to make ourselves rich, or that vaccines cause autism.

the sad part is, it is people with your approach to medicine that leaves me looking like the ****ing grim-reaper when I tell family that they're loved ones are going to die, and that there is NOTHING that can be done and that they have 30 minutes to come to grips with that reality, instead of having incremintal doses of reality along the way.

 

[long]

If there's evidence for a therapy's effectiveness, then it isn't technically CAM anymore. Just sayin'.

 

[ArcGurren]

If there's evidence for a therapy's effectiveness, then it isn't technically CAM anymore. Just sayin'.

Not necessarily. CAM is often classified as being as such purely because it isn't traditional allo medicine. I've heard of people refer to OMM as CAM even though that's stretching the definition quite a lot since there is some validity to many of the DO manipulations.

Anyway... for minor issues I see no problem with CAM myself. Things like herbs, spices etc have some basis in science for improving conditions like depression, memory, etc. Whether they're dressed up in traditions like Ayurveda or not they're still considered evidence-based CAM. I do to some extent believe in the efficacy of Ayurveda as it applies to herbology and acupuncture.

The rest of the stuff is either spiritual in nature (again, YMMV) or junk/pseudo-science.

 

[MrBigglesworth]

Georgetown has a CAM masters. (1 year). I wouldn't advise on enrolling in the masters because most people take that as a shoe-in to other programs usually (pseud-smp). Also, as you know, no one can teach you better than you can teach yourself. I would suggest you email Dr. Sherman over there and ask for book recommendations. He's a good man.

 

[medhearter]

at you're arguing for is non-sequatoric in your approach, you want to farm out people we have no treatment for to these people whom to date and despite research have shown little to no in the way of scietifically vialbe treatments for diseases? and then reserach their methods to show validity? no thank you. you'll just feed into the masses that think we're hiding the cure for cancer, or are keeping people sick to make ourselves rich, or that vaccines cause autism.

the sad part is, it is people with your approach to medicine that leaves me looking like the ****ing grim-reaper when I tell family that they're loved ones are going to die, and that there is NOTHING that can be done and that they have 30 minutes to come to grips with that reality, instead of having incremintal doses of reality along the way.

i wasn't talking only about terminal illness. any approach would have more chances of being successful if treatment is administered at an earlier period of the disease process. what i'm trying to say is, be it CAM or traditional allopathy, so long as we are doing everything to address a patients state of unhealth, it is good. CAM approaches typically appear benign, but when practiced in the right way can be a very useful way to boost an individual's state of health, in conjunction with whatever other treatments that may be needed more acutely. thats where the concept of integrative medicine comes in. its about treating the patient as a whole, and not turning a blind eye to evidenced approaches that have the potential to be helpful. if it happens to be something that is labelled as a CAM, but is evidenced and helpful, then there needn't be a taboo about it.

 

[Hernandez]

i wasn't talking about terminal illness. i'm more interested in disease processes. any treatment would be more effective in an earlier period of the disease process. what i'm trying to say is, be it CAM or traditional allopathy, so long as we are doing everything to address a patients state of unhealth, it is good. thats where the concept of integrative medicine comes in. its about treating the patient as a whole, and not turning a blind eye to evidenced approaches that have the potential to be helpful.

evidenced? the NIH spends $200 million a year on CAM research and what effective evidenced results have they shown?

 

[medhearter]

evidenced? the NIH spends $200 million a year on CAM research and what effective evidenced results have they shown?

With all due respect, not acknowledging the value of something doesn't necessitate that it isn't valuable.

You are free to read up on findings and research. Start somewhere.

http://nccam.nih.gov/health/atoz.htm

If you have constructive advice to improve this field of research, you are welcome to share it.

 

[Law2Doc]

If there's evidence for a therapy's effectiveness, then it isn't technically CAM anymore. Just sayin'.

Agreed. Once there is evidentiary support it gets quickly embraced and pulled into the realm of allopathic medicine. Things like accupuncture are slowly becoming accepted based on demonstration of efficacy. That's really the catch of alternative medicine -- it really isn't an alternative. Once it gets shown to work, it becomes traditional because they have jumped through the EBM hoops. So instead of traditional medicine and alternative medicine, it really needs to be looked at as proven medicine vs unproven methods. And as a physician you need to stand fast against unproven things, because there is no such thing as a benign drug -- they all have side effects. Unless there is a demonstration of efficacy that outweighs those side effects it is simply dangerous to "let" your patients go that route, even if traditional medicine hasn't helped them. They can always be made sicker, no matter how bad off they are.

 

[Law2Doc]

... CAM approaches typically appear benign, ...if it happens to be something that is labelled as a CAM, but is evidenced and helpful, then there needn't be a taboo about it.

there are no benign drugs or treatments -- they all have side effects, interactions, etc. Once there is evidence, they are EBM, not CAM. Until then they are not a viable "alternative" and doctors ought not suggest them.

 

[medhearter]

Agreed. Once there is evidentiary support it gets quickly embraced and pulled into the realm of allopathic medicine. Things like accupuncture are slowly becoming accepted based on demonstration of efficacy. That's really the catch of alternative medicine -- it really isn't an alternative. Once it gets shown to work, it becomes traditional because they have jumped through the EBM hoops. So instead of traditional medicine and alternative medicine, it really needs to be looked at as proven medicine vs unproven methods. And as a physician you need to stand fast against unproven things, because there is no such thing as a benign drug -- they all have side effects. Unless there is a demonstration of efficacy that outweighs those side effects it is simply dangerous to "let" your patients go that route, even if traditional medicine hasn't helped them. They can always be made sicker, no matter how bad off they are.

agreed. whatever the semantics, the appraisal and appropriate evaluation of alternatives is needed, being done, and people especially in the medical profession should be aware of it, its implications, and how to make it more effective.

 

[TexasPhysician]

Id recommend attending CAM national conferences no matter where you attend medical school.

 

[Law2Doc]

agreed. whatever the semantics, the appraisal and appropriate evaluation of alternatives is needed, being done, and people especially in the medical profession should be aware of it, its implications, and how to make it more effective.

But the semantics are everything here. There are folks who are making careers out of peddling shark fin and ginko berries precisely because they are allowed to call it "alternative" "medicine". It is neither. What it is is non-evidence based crap (NEBC). That's what it needs to be called, so the public can make an informed decision. The public is being duped by this being called alternative medicine because they really don't understand that this is not a viable alternative and not medicine. Once something is proved, it gets pulled under the heading of evidenciary based medicine (ie traditional medicine). But until that point, it really should be exposed for what it is -- a dangerous set of wives tales which can harm you on top of not having been proved to be effective. And doctors should strongly emphasize this to their patients who have these "alternative" leanings.

 

[Danlee07]

so sending them out for unscientific, false hope or worse giving them medication that isn't indicated is better than being honest that in this day and age we can't treat their disease? these situations are where phase 1-3 trials are needed, and why we should be wasting money on CAM, when we have real science looking into the how and why's and looking for safe, reliable methods of treatment.

I see your side, but I have some questions too. I don't think you've really seen Eastern medicine.... it's not really just eating weird things as aphrodisiacs or pain relief, but it's more of the mind set. The most laconic way I can explain the difference at the moment is that Western medicine approach aims to directly influence the body to accept/reject a necessary function while the Eastern medicine approach aims to directly influence the well-being state of energy... sounds like bull. however, things like herbal concoctions are administered before or after surgery in Eastern medicine. for example, for hernias, unless a grade IV hernia, the first approach may be the same with all Western doctors... administer medicine. that medicine is different...

take a look at this:
http://www.ncbi.nlm.nih.gov/pubmed/21721154

your premise that everything needs a phase 1-3 is not substantial... marketing also factors into the trials. many drugs that aren't targeted to a large enough audience don't even make it to phase 1.

I'm not sure, but are things like herbal classified as CAM or already allopathic? in either case, the general view to the Eastern approach seems very disoriented. also, the statement that 'once proven, 'doctors can administer such a method' seems to give credit only to Western approach and that Eastern is not proven so it's classified as CAM and non-reliable.

 

[Hernandez]

I see your side, but I have some questions too. I don't think you've really seen Eastern medicine.... it's not really just eating weird things as aphrodisiacs or pain relief, but it's more of the mind set.

so spirituality plus placebo.....got it...

your premise that everything needs a phase 1-3 is not substantial... marketing also factors into the trials. many drugs that aren't targeted to a large enough audience don't even make it to phase 1.

so you'd just do away with all physiologic based research and give them free reign?

I'm not sure, but are things like herbal classified as CAM or already allopathic? in either case, the general view to the Eastern approach seems very disoriented. also, the statement that 'once proven, 'doctors can administer such a method' seems to give credit only to Western approach and that Eastern is not proven so it's classified as CAM and non-reliable.

the bulk of voodoo practitioners I've run into are snake oil salesme who are simply in it to make a few bucks, but the bigger problem I have with the science of it is the almost complete lack of adherence to the scientific principle in their studies. I've been on the CAM site, and frankly their research doesn't Give enough info t even try and reproduce their findings, much less be able to find what might have actually led to any positive findings

 

[Danlee07]

so spirituality plus placebo.....got it...
somewhat, but only a minority of the treatment.

so you'd just do away with all physiologic based research and give them free reign?

no, factors such as audience get involved so not every drug/method that wasn't tested in phases should be automatically discounted; they could be very efficacious. the physiologic research must be done, but I'm stating that the requirement to begin the phase testing is not solely to test whether the drug works or not.

the bulk of voodoo practitioners I've run into are snake oil salesme who are simply in it to make a few bucks, but the bigger problem I have with the science of it is the almost complete lack of adherence to the scientific principle in their studies. I've been on the CAM site, and frankly their research doesn't Give enough info t even try and reproduce their findings, much less be able to find what might have actually led to any positive findings

The techniques that you look down upon are many that are also looked down upon in Eastern medicine as well...
And taking a brief look at the site, I definitely should clarify: Eastern medicine isn't CAM. Eastern medicine uses alternative techniques such as prescribing mainly herbal based pills rather than prescribing Valium ... along with standard practice such as surgery. There are also people who in direct language translation are called neither doctors nor chiropractors, but focus on rehabilitation...research is done, but I haven't seen one in English...

 

[medhearter]

I see your side, but I have some questions too. I don't think you've really seen Eastern medicine.... it's not really just eating weird things as aphrodisiacs or pain relief, but it's more of the mind set.

it is actually somewhat difficult to conduct scientific research on "Eastern Medicine" because of this aspect of its nature. It is multi-factorial, involves numerous aspects of a patient's lifestyle, and addresses not only the chief complaint but supports overall health as a patient may have weaker points. One singular herb would never be all that an Eastern medicine doctor would prescribe, and the treatment would vary from patient to patient, even with the same condition, taking into account all aspects of patient's constitution.

Actually, to be honest, doctors with this kind of mindset that practice "Western medicine" probably do well for their patients as well. Treat the chief complaint, but also support overall health, whether that involves specific nutritional supplements, talk therapy, or whatever else within the realm of allopathic medicine that can be tailored to support the patient's healing more comprehensively. This is "comprehensive medicine", I believe, since we like semantics in this forum 🙂

In any case, with "Eastern" or "alternative" medicine, if significance is found on one singular herb, its important to follow-up with more complex studies, involving entire treatment plans as they are actually practiced. these need be described in detail, so that they may be replicated, and with appropriate controls.

 

[adaptation1]

I believe in complete separation between western medicine and eastern medicine, especially TCM. If you want to learn western medicine, learn it well. If you want to learn eastern medicine, learn that well. Don't mix.

The reason is that poor practitioners of TCM often attempt to apply the western approach of medicine to eastern medicine, fail miserably, and diminish their effectiveness as TCM practitioners; similarly, allopathic practitioners dabbling in and experimenting with TCM--while still engaging in the allopathic mindset-- is ultimate fail, often disastrous, as they neglect their own expertise, becoming mediocre physicians, and then make the situation even worse by practicing "TCM" completely wrong. Western and eastern medicine have completely different philosophies toward healing, and they are both effective--and arguably only effective-- within the context of their respective practices.

The herbology system of TCM is advanced, taking years to master. Typical TCM doctors in China go through rigorous training--often for 6-7 years, with clinical exposure as rigorous as any residency here in the US--to gain a grasp of nature and fundamentals of herbs, using the TCM way of thinking.

And then comes a Western MD, experimenting superficially with CAM, who prescribes gingko--a single herb--to improve brain circulation for all their patients, because it's one of more studied herbs in the western literature. In TCM, no practitioner in their right mind would prescribe gingko as a single herb without other herbs to dampen its side effects; every patient is also prescribed a different concoction of herbs according to their diagnosis; furthermore, there are plenty of herbs that are known to be better circulatory agents in the TCM catalogue than gingko. Finally, in TCM, poor brain function may often be result of poor spleen or liver function--not the brain-- two organs that don't have any physical realities in TCM, but actually correspond with the parasympathetic and sympathetic nervous system respectively. Practitioners may prescribe a balanced concoction herbs to harmonize the two systems.

So double blinded studies for single herbs to prove their efficacy for a single condition? There's absolutely no point!!!. Tcm doctors would never prescribe a single herb, would never prescribe the same herbs to different patients just because they have the same "condition" as defined in western pathology, and most importantly the best tcm physicians NEVER use herbs as their single weapon, but use them in conjunction with specific lifestyle changes and other modalities such as acupuncture and qi gong.

What I said is only scratching the surface. True TCM is deep, cultural, and DIFFICULT TO PRACTICE, professionalism and efficacy honed by years of experience and devotion to the art -- just as western physicians have payed their dues to gain strength in trades. The terminology and prescribing patterns are in a different language than western medicine, and mastery of both western and TCM vernacular is almost impossible.

So let's not be dilettante MDs that make a free throw and claim we play in the NBA. Nor should eastern physicians should claim any grasp of western medicine. We should stick with what we're good at.

And so while I love TCM, now that I'm in med school in the US, I've completely given up the notion that I will someday apply it in my own practice, unless I work alongside an experienced TCM practitioner with rigorous clinical training. Which is not likely in the US, given the weak training most TCM practitioners receive in the US. I'm just going to learn western medicine well and benefit my patients to the greatest extent western medicine allows.


Just my two cents.

 

[medhearter]

I believe in complete separation between western medicine and eastern medicine, especially TCM. If you want to learn western medicine, learn it well. If you want to learn eastern medicine, learn that well. Don't mix.

The reason is that poor practitioners of TCM often attempt to apply the western approach of medicine to eastern medicine, fail miserably, and diminish their effectiveness as TCM practitioners; similarly, allopathic practitioners dabbling in and experimenting with TCM--while still engaging in the allopathic mindset-- is ultimate fail, often disastrous, as they neglect their own expertise, becoming mediocre physicians, and then make the situation even worse by practicing "TCM" completely wrong. Western and eastern medicine have completely different philosophies toward healing, and they are both effective--and arguably only effective-- within the context of their respective practices.

The herbology system of TCM is advanced, taking years to master. Typical TCM doctors in China go through rigorous training--often for 6-7 years, with clinical exposure as rigorous as any residency here in the US--to gain a grasp of nature and fundamentals of herbs, using the TCM way of thinking.

And then comes a Western MD, experimenting superficially with CAM, who prescribes gingko--a single herb--to improve brain circulation for all their patients, because it's one of more studied herbs in the western literature. In TCM, no practitioner in their right mind would prescribe gingko as a single herb without other herbs to dampen its side effects; every patient is also prescribed a different concoction of herbs according to their diagnosis; furthermore, there are plenty of herbs that are known to be better circulatory agents in the TCM catalogue than gingko. Finally, in TCM, poor brain function may often be result of poor spleen or liver function--not the brain-- two organs that don't have any physical realities in TCM, but actually correspond with the parasympathetic and sympathetic nervous system respectively. Practitioners may prescribe a balanced concoction herbs to harmonize the two systems.

So double blinded studies for single herbs to prove their efficacy for a single condition? There's absolutely no point!!!. Tcm doctors would never prescribe a single herb, would never prescribe the same herbs to different patients just because they have the same "condition" as defined in western pathology, and most importantly the best tcm physicians NEVER use herbs as their single weapon, but use them in conjunction with specific lifestyle changes and other modalities such as acupuncture and qi gong.

What I said is only scratching the surface. True TCM is deep, cultural, and DIFFICULT TO PRACTICE, professionalism and efficacy honed by years of experience and devotion to the art -- just as western physicians have payed their dues to gain strength in trades. The terminology and prescribing patterns are in a different language than western medicine, and mastery of both western and TCM vernacular is almost impossible.

So let's not be dilettante MDs that make a free throw and claim we play in the NBA. Nor should eastern physicians should claim any grasp of western medicine. We should stick with what we're good at.

And so while I love TCM, now that I'm in med school in the US, I've completely given up the notion that I will someday apply it in my own practice, unless I work alongside an experienced TCM practitioner with rigorous clinical training. Which is not likely in the US, given the weak training most TCM practitioners receive in the US. I'm just going to learn western medicine well and benefit my patients to the greatest extent western medicine allows.


Just my two cents.

thank you for your response. thats a valuable two cents 🙂. i think thats where multi-disciplinary teams could come in. there are integrative medicine centers in some locations that have doctors of various allopathic specialties, as well as say, chiropractors, dietitians, chinese medicine doctors, ayurvedic physicians, all working together, or atleast, refering patients to each other. i haven't observed these kind of settings or how they work, but hopefully will try to when I get back to DC.

 

[patel2]

also, any ideas on CAM-friendly and CAM-promoting institutions? perhaps schools that conduct research in CAM and can hence indicate its translation it into regular clinical practice

My interest lies in practicing CAM in conjunction with the traditional allopathy.

Specialty interests are broad, but include oncology and neurology.

I don't know who you are. I don't know what you want. If you are looking for ransom, I can tell you I don't have money. But what I do have are a very particular set of skills; skills I have acquired over a very long career. Skills that make me a nightmare for people like you. If you let my daughter go now, that'll be the end of it. I will not look for you, I will not pursue you. But if you don't, I will look for you, I will find you, and I will kill you.
http://www.imdb.com/name/nm0048076/

 

[DrDrummer]

From a more philosophical side of things-- it takes him a while to get there, but I think the author of this short essay hits on at least part of the reasons that more and more Americans are turning towards alternative approaches to healthcare and healing:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2605310/?tool=pubmed

 

[FutureDr8429033]

I believe in complete separation between western medicine and eastern medicine, especially TCM. If you want to learn western medicine, learn it well. If you want to learn eastern medicine, learn that well. Don't mix.

The reason is that poor practitioners of TCM often attempt to apply the western approach of medicine to eastern medicine, fail miserably, and diminish their effectiveness as TCM practitioners; similarly, allopathic practitioners dabbling in and experimenting with TCM--while still engaging in the allopathic mindset-- is ultimate fail, often disastrous, as they neglect their own expertise, becoming mediocre physicians, and then make the situation even worse by practicing "TCM" completely wrong. Western and eastern medicine have completely different philosophies toward healing, and they are both effective--and arguably only effective-- within the context of their respective practices.

The herbology system of TCM is advanced, taking years to master. Typical TCM doctors in China go through rigorous training--often for 6-7 years, with clinical exposure as rigorous as any residency here in the US--to gain a grasp of nature and fundamentals of herbs, using the TCM way of thinking.

And then comes a Western MD, experimenting superficially with CAM, who prescribes gingko--a single herb--to improve brain circulation for all their patients, because it's one of more studied herbs in the western literature. In TCM, no practitioner in their right mind would prescribe gingko as a single herb without other herbs to dampen its side effects; every patient is also prescribed a different concoction of herbs according to their diagnosis; furthermore, there are plenty of herbs that are known to be better circulatory agents in the TCM catalogue than gingko. Finally, in TCM, poor brain function may often be result of poor spleen or liver function--not the brain-- two organs that don't have any physical realities in TCM, but actually correspond with the parasympathetic and sympathetic nervous system respectively. Practitioners may prescribe a balanced concoction herbs to harmonize the two systems.

So double blinded studies for single herbs to prove their efficacy for a single condition? There's absolutely no point!!!. Tcm doctors would never prescribe a single herb, would never prescribe the same herbs to different patients just because they have the same "condition" as defined in western pathology, and most importantly the best tcm physicians NEVER use herbs as their single weapon, but use them in conjunction with specific lifestyle changes and other modalities such as acupuncture and qi gong.

What I said is only scratching the surface. True TCM is deep, cultural, and DIFFICULT TO PRACTICE, professionalism and efficacy honed by years of experience and devotion to the art -- just as western physicians have payed their dues to gain strength in trades. The terminology and prescribing patterns are in a different language than western medicine, and mastery of both western and TCM vernacular is almost impossible.

So let's not be dilettante MDs that make a free throw and claim we play in the NBA. Nor should eastern physicians should claim any grasp of western medicine. We should stick with what we're good at.

And so while I love TCM, now that I'm in med school in the US, I've completely given up the notion that I will someday apply it in my own practice, unless I work alongside an experienced TCM practitioner with rigorous clinical training. Which is not likely in the US, given the weak training most TCM practitioners receive in the US. I'm just going to learn western medicine well and benefit my patients to the greatest extent western medicine allows.


Just my two cents.

You really drank the kool-aid didn't you? That or liver qi stagnation is affecting your brain. I'd recommend Liver-3 and Large Intestine-4, but I can't be sure without seeing your tongue and feeling your pulse. In the guan position, not cun or chi, that would be ridiculous. Also, instead of LIV-3 and LI-4, I'll just use random points because it doesn't seem to matter where needles are inserted. Also, I'll use toothpicks instead of needles, because it doesn't seem to matter if needles are inserted at all.

Despite all of your conjecture about physicians using TCM/TCM practitioners trying to practice based on "Western" medical principles, this stuff actually IS testable. Find 500 people diagnosed as spleen qi deficient (have a really old asian guy make that dx. if it makes you feel better), randomly assign them to si jun zi tang or placebo.....you see where I'm going here? I think you do. And your hand waving about how impossible it is to test TCM doesn't then make it okay for TCM to be used for everything and anything (and it is) with no expectation of evidential support.

Be honest. You want a double-standard between CAM and conventional medicine. The highest standard of evidence should exist for modern medical interventions, and CAM should get a free pass because, hey, it's hard to test and the largest, most well-controlled clinical trials blow you guys out of the water.

 

[vanbamm]

The middle ground between CAM and allopathic treatment has not been established yet. a working relationship between the two can be found, but is rare due to the fact that most of the times it doesnt work out because the two sides don't totally agree- one a positive note, both sides, to an extent, are making more of an effort- i can say that chiropractic is becoming evidence based, due to insurance reimbursements, and allopathic and osteopathic doctors have the opportunity to take continuing education in CAM therapy- Dr. Weil created a program at the University of Arizona that allows MD/DO's to do distance learning plus 3 weeks or so of on site learning in order to become familiar with CAM practices and even learn and integrate the skills into their own approach- I think it is a good program- if you want to learn it and use it, it makes more sense to do that than pay someone else to do it.

 

[adaptation1]

Actually, you are completely right!!! And I've always been honest.

I do want TCM to get a free pass, so to speak, in that I hope it is NOT practiced in the US and that it is completely banned, with all the quacks' acupuncture licenses removed and crap herbs taken off the market. Allopathic care here is already the pinnical of civilization achievement, and ethical, evidence-based medicine is held in highest regard and practiced with absolute stringency.

But I want TCM to stay in China where it belongs, as a cultural relic with absolutely no efficacy, where ethical standards are much lower: where TCM stands on equal footing with western medicine in hospitals, where those idiot TCM practitioners have been using it for 5000 years, to absolutely no results, of course, and where it is (still!!!) used despite lacking and paltry evidence. And I'm serious. Why dilute a culturally-based and ineffective art and have americans like us ridicule it like no other? Let those chinese people enjoy--or suffer, more likely!--the nauseating placebo effect that is TCM, for themselves. Don't bring us into it.

btw, i do have liver qi stagnation in my brain. but i doubt you know what that means any more than I do. And I don't know what it means.

You really drank the kool-aid didn't you? That or liver qi stagnation is affecting your brain. I'd recommend Liver-3 and Large Intestine-4, but I can't be sure without seeing your tongue and feeling your pulse. In the guan position, not cun or chi, that would be ridiculous. Also, instead of LIV-3 and LI-4, I'll just use random points because it doesn't seem to matter where needles are inserted. Also, I'll use toothpicks instead of needles, because it doesn't seem to matter if needles are inserted at all.

Despite all of your conjecture about physicians using TCM/TCM practitioners trying to practice based on "Western" medical principles, this stuff actually IS testable. Find 500 people diagnosed as spleen qi deficient (have a really old asian guy make that dx. if it makes you feel better), randomly assign them to si jun zi tang or placebo.....you see where I'm going here? I think you do. And your hand waving about how impossible it is to test TCM doesn't then make it okay for TCM to be used for everything and anything (and it is) with no expectation of evidential support.

Be honest. You want a double-standard between CAM and conventional medicine. The highest standard of evidence should exist for modern medical interventions, and CAM should get a free pass because, hey, it's hard to test and the largest, most well-controlled clinical trials blow you guys out of the water.

 

[High Roller]

Hello,

Share thoughts.

I think its a sham.

Don't get me wrong, theres a lot of holistic values that docs don't pay attention to; and we underutilize many resources such as social workers, therapists, dietitians, etc. But complementary medicine and its treatments are given a double standard and the folks practicing it are salesmen at heart.

I think taking a holistic approach to patient care is awesome and we need more docs who do it. Some stuff that comes to mind include focusing more on diet & exercise, stress, happiness and quality of life, etc. But all that stuff is different than 'complementary' medicine and has evidence behind it...hence don't confuse the two.

 

[High Roller]

Agreed. Once there is evidentiary support it gets quickly embraced and pulled into the realm of allopathic medicine. Things like accupuncture are slowly becoming accepted based on demonstration of efficacy. That's really the catch of alternative medicine -- it really isn't an alternative. Once it gets shown to work, it becomes traditional because they have jumped through the EBM hoops. So instead of traditional medicine and alternative medicine, it really needs to be looked at as proven medicine vs unproven methods. And as a physician you need to stand fast against unproven things, because there is no such thing as a benign drug -- they all have side effects. Unless there is a demonstration of efficacy that outweighs those side effects it is simply dangerous to "let" your patients go that route, even if traditional medicine hasn't helped them. They can always be made sicker, no matter how bad off they are.

Just realized someone said it 100 times better than I can.

 

[FutureDr8429033]

Just realized someone said it 100 times better than I can.

Yeah, but homeboy has it 100% wrong about acupuncture, and I don't think the word "traditional" means what he thinks it means.