I've got that sinking feeling...
Another weekend article for angry doc to mull over in Today today. This one is titled
'It's sinking in - Traditional Chinese Medicine is gaining acceptance, but on Western medicine's terms'.
The article is rather long (and so I won't reproduce it in full here) and it took angry doc a few readings to digest, but the author's main point seems to be that acceptance of traditional Chinese medicine (TCM) into the 'mainstream' is dependent on western doctors.
Here's how her argument goes:
The author starts by telling us that cells from the herb cordyceps is being cultured in Science Park.
(But of course the fact that a herb is being produced for commercial purposes is not proof of its efficacy, just of it commercial value - it might just as well be rhino horn cells being cultured.)
This is followed by an account of a young double-degree holder who decided to become an acupuncturist because acupuncture worked for her mother.
(An admirable personal decision, no doubt, but hardly scientific evidence that all of TCM 'works'.)
The article goes on to describe how TCM is being integrated into our traditional (western) medical practice, with public hospitals having TCM centres on their premises, and more western doctors taking up TCM courses.
However, the author notes, this is not a 'full embrace' of TCM, since:
1. The Ministry of Health's position on TCM is as follows:
"There is a sizeable number of people who will use TCM whether you like it or not, and that is why the MOH needs to regulate TCM practitioners, and make sure that the practitioners are trained and are qualified to give that kind of treatment.
"That is the only reason why the MOH regulates practitioners — not because we support TCM or promote TCM. In fact, all we want to do is to make sure that people who want to use TCM use it safely."
(I won't gloat, because one can say the very same thing about western medicine, or some of the practices within western medicine.)
2. Only about 25% of western doctors accept TCM, and the rest are 'wary' and sceptical of TCM because it 'operates on the different paradigm of meridians and energy, which is foreign to Western medicine'.
The author concludes that "it's how the Western medical camp embraces TCM that will determine its future direction".
Wow. All of the sudden the 75% of doctors who do not accept TCM are guilty of preventing it from being 'fully embraced' and accepted into the 'mainstream'.
Well, if that's really the truth, then angry doc is proud to be one of those obstructionist jerks. At least in his professional capacity anyway – how I feel about TCM as a person is largely irrelevant, since I am licensed as a western doctor.
As I have mentioned before, whether TCM is accepted into the 'mainstream' or not is largely a social issue and not a medical one. A lot of people already 'use' TCM, and I don't think it bothers them an awful lot whether or not we western doctors agree with them as long as TCM works for them. Insurance companies are free to decide if they will accept claims for TCM treatment, and individual employers are free to decide if they want to accept medical leave issued by TCM practitioners. I don't have a problem with that.
What bothers me however is the author's suggestion that there should be a 'full embrace' of TCM by western doctors.
That's rubbish. (Yes, I don't usually use such strong language, but it's the weekend.)
Western doctors should be wary and sceptical of medical disciplines that operate on a different paradigm. That’s why we underwent years of study and training on foundation sciences. That's why we continue to subject new drugs, new devices, and new treatment protocols to studies and trials.
All that is not to say that all TCM therapies and pharmaceuticals do not work, or that none of TCM should be studied or integrated in our medical system. We have an existing system of testing therapies to see if they work, and TCM therapies and pharmaceuticals should be tested individually, and not accepted as a 'full' package because it has a paradigm different from our own.
I don't buy the argument that the therapies and treatments must be accepted together with the whole philosophy to work. Medicine may be an art and a science, but it is not medicine without the science. And while science is a subset of philosophy, not all of philosophy is science.
Western medicine used to come with a philosphy of 'humours', but we've left that behind. You may argue that modern western medicine comes with its own philosophy, but you don't have to believe in the concept of antibiotics for penicillin to cure your infection.
If a method of diagnosis, a modality of investigation, or a mode of treatment works, it should work regardless of whether you believe in the philosophy behind it or not.
We all should be very worried if western doctors embraced an entire medical discipline wholesale just because a lab is making a herb used by it commercially, or that one therapy in that discipline worked for one double-degree holder's mother.