Angry Doctor

Tuesday, September 12, 2006

One billion Chinese Yuan can't be wrong

An interesting piece of news tucked away in the corner of the page in today's Today.

Chinese TCM docs may practise here

SHANGHAI — Singapore may allow Traditional Chinese Medicine (TCM) physicians from China to practise in Singapore.

Disclosing this to reporters during his trip to China, Minister of State for Trade and Industry Lee Yi Shyan said this may be explored further in the free-trade agreement being discussed between China and Singapore. Currently, physicians and acupuncturists need to register with the TCM Practitioners Board, a regulatory body set up in 2001, before they can practise in Singapore.

Meanwhile, Singapore's largest public health care group, SingHealth, is in talks with Chinese authorities to set up a high-end private hospital in Shanghai, targeted at the expatriate community there. — Channel NewsAsia

angry doc notes two things:

1. The announcement was made by the Minister of State for Trade and Industry, and not someone from the Health Ministry.

2. If TCM is so good that we want to 'import' more of it to Singapore, what makes them think that 'exported' western medicine will be in demand over at the home of TCM?

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  • Hi angry doc,
    How not to be angry?
    We are powerless to do anything.
    The day is coming very soon when the TCM's MC is recognised by the civil service ( & then thereafter by every employer).
    Market forces of supply and demand will then force a lot of doctors to be tempted to practise other than evidence-based medicine.
    Cheers ( but nothing to cheer about),

    By Blogger nofearSingapore, At September 13, 2006 3:10 pm  

  • Dr Huang,

    Thanks for dropping by. I am a reader of your blog.

    Yes, if the ministry promotes TCM use, then they likely have to extend medical coverage for civil servants to include TCM, and they will also have to recognise TCM MCs.

    By Blogger angry doc, At September 13, 2006 5:52 pm  

  • Hi
    And that, I am sure you would agree,is not good for the heartland GP's.
    That's life.
    World is changing and we have to accept that Medicine is just like any other job. It is a business.
    Those of us who still view it as a noble profession is fated to be disappointed. Sigh!



    By Blogger nofearSingapore, At September 13, 2006 6:39 pm  

  • It probably will be bad for GPs, but then again I am not against that.

    I am not even against the idea of people/patients choosing to use TCM over western medicine - I believe a person has the right to choose whatever treatment he wants for himself, regardless of the efficacy, as long as he is willing to take responsibility for his choice.

    The only bit I have problem with is the possibility that public fund may be used to pay for unproven modes of therapy.

    By Blogger angry doc, At September 13, 2006 7:16 pm  

  • It's good for MOH 'cos treatment at TCM clinics will be completely at patient's own expense and there is no need for MOH subsidy.

    I do not think public funds will ever be used for this purpose.

    By Anonymous Anonymous, At September 14, 2006 5:02 am  

  • "Those of us who still view it as a noble profession is fated to be disappointed. Sigh!"

    Not you right Dr Huang? :lol:

    Definitely not me! Haha! Read my entry on "Drs are evil"?

    By Blogger Dr Oz bloke, At September 14, 2006 1:50 pm  

  • Actually as far as I am concerned. No problem.

    This is just competition.

    I'll just have to study TCM and compete as well.

    Very soon there might be TCM specialists coming as well and then you specialists would experience what we GPs are going through. In fact it's bound to happen!

    Don't say I never warned you! haha!

    By Blogger Dr Oz bloke, At September 14, 2006 1:52 pm  

  • Anon,

    Civil servants whose medical bills are covered by their employers effectively have their medical bills paid for with public funds.

    When that happens (and if it becomes known), it is natural for the public to ask why the same coverage is not extended to them via medical subsidy.

    After all, the current MOH position is that if a mode of treatment is proven and effective it will be subsidised. So if they will not subsidise TCM for the public at large and yet cover civil servants for TCM treatment, then the incongruence will need to be explained.

    The incongruence in the acceptance of MCs has been raised a few times (and discussed on this blog) before, so I think it is probable that the public will pick up on the issue and raise questions.

    Not that they will necessarily be answered, of course; the letters on MC acceptance have not been, as far as I am aware.

    If they will not cover TCM treatment for civil servants or recognise TCM MCs, but at the same time continue to promote TCM, they will still face questions for their stance.

    By Blogger angry doc, At September 14, 2006 5:21 pm  

  • Hi friends,
    dr oz bloke: Ya I better sign up for some acupuncture course. Will be the first one in Sg to use it for Tonsillectomy or tympanoplasty. Don't need anaesthetists ( maybe jack up my fees to include anaesthetist's portion - ha ha ha!)
    But seriously, I am a skeptic for most of the TCM stuff ( except for the massage/physio portion). In fact the venerated Prof Emeritus Wong Hock Boon ( v v famous paediatrian) got lots of flak for saying - You might as well eat grass!. Those days one can say political incorrect stuff. Now we will be crucified!
    angry doc: The day for TCM MC recognition is not far away, I am sure!

    By Blogger nofearSingapore, At September 14, 2006 5:38 pm  

  • Dr H,

    I find your comments very typical of people who do not know enough about something that is in competition with them. Skepticism.

    Most times we brush away things that threaten us even if we know almost close to nothing substantial about it.

    But when we do learn more about it.....maybe opinions will change.

    Anyway heard of the latest drug for hypertriglyceridemia approved by the FDA? It's called OMACOR. Go google it!

    By Blogger Dr Oz bloke, At September 14, 2006 11:28 pm  

  • Hi dr oz bloke,
    Mea culpa.
    I plead guilty. I was just being honest.
    OK! I will try not to be skeptical about anything that I know almost nothing about, esply if these same things are in competition with my trade!
    Gulp! ( sound of me swallowing my pride)

    By Blogger nofearSingapore, At September 15, 2006 12:01 am  

  • There are many chornic dieases that western medicine only have symptomatic relieve. Somehow some TCM praticioners managed to cure it. Of course they are just anecdotal evidence.

    My aunt went china for transplant. They used acuputure for the anaesthesia. It actually works.

    So there are actually a lot of good in TCM. The only problem is standardisation because it varies according to skills.

    Even when they take the pulse many people would not get it right but some experts can really tell what problems you have. It is a skill that requires talent.

    By Blogger palmist, At September 15, 2006 1:27 am  

  • Oz Bloke,

    I don't get your point.

    Omacor shows that western medicine continues to examine and accept treatments that are proven to work. It certainly does not prove that all of TCM works. Neither does it help with tonsillectomy or tympanoplasty.


    I am pretty sure your aunt did not have *only* acupuncture for anaesthesia.

    By Blogger angry doc, At September 15, 2006 8:32 am  

  • Hi Angrydoc,

    the point regarding OMACOR is this....

    Studies showing that Omega 3 fatty acids lowered TG and reduced mortality in cardiac patients has been around for a long time now.

    The USA FDA sure took a long time in approving claims for Omega 3 fatty acids! In fact I still recall cardiologists teaching me at CMEs that fish oil was nonsense!

    You might also want to check out the price of OMACOR. For the equivalent amount and concentration of EPA/DHA, OMACOR is almost 8 times the price of an equivalent fish oil EPA/DHA supplement in health food stores!

    Anyway OMACOR has nothing to do with TCM. It is about the US FDA.

    In June 2006, a federal appellate court ruled against the FDA.

    If you are a terminally ill patient with a 100% certainty of dying in the USA, it is illegal for you to try an experimental drug/treatment that has not been approved by the FDA.

    The FDA's position has always been that it has to "protect" the terminally ill from unproven therapies.

    So people sit around waiting to die, while the FDA takes its times to decide.

    Well the federal courts have ruled that in such situations, if the drug in questions has cleared Phase I trials, it is ok for the patients to try them.

    As long we do no harm....and the patients are told that it is still experimental etc. Why not?

    I am tempted as a western medical doctor to say to MOH that we should not allow all these non-evidence based therapies into Singapore etc etc etc. But really, if you think about it, what is the real reason we say as such?


    By Blogger Dr Oz bloke, At September 15, 2006 11:25 pm  

  • Oz Bloke,

    You say OMACOR has nothing to do with TCM, but you bring it up in a discussion about TCM.

    You have used such an argument before, citing the examples of H.pylori and aspirin.

    But the fact is just because *some* previously unproven therapies later becomes proven and accepted does not mean that we should accepted *all* unproven therapies.

    Most alternative medicine disciplines do not treat life-and-death or terminal conditions, so your example of the trial is a red herring. I believe the drug in question is also not an alternative medicine remedy?

    By Blogger angry doc, At September 16, 2006 9:36 am  

  • "But the fact is just because *some* previously unproven therapies later becomes proven and accepted does not mean that we should accepted *all* unproven therapies"

    And i recall linking you to some of the studies before and you said you were not aware of them before.

    Anyway looking at the above I am not disputing the *all* part. But the "accpeting" and implied *rejecting*.

    I think we should accept *SOME* but not all unproven therapies. For the matter is it up to us western doctors to decide what is accepted and what is not? Is it not for the patients to choose?

    Perhaps my comments have come off badly. I can understand why cos I wasn't really trying to be totally politically correct.

    Just to set the record straight.

    I am not forcing my opinions on anybody. I do not say that you should be as accepting as I am. All I am doing is to suggest that there is more information out there and perhaps we might want to take a look at it more before we make judgements.

    Peace man :)

    By Blogger Dr Oz bloke, At September 16, 2006 4:01 pm  

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