It’s summer between my second and third year of school in Classical Chinese medicine. I’ve had these past two summers “off” which means I do a lot of studying and thinking and many odd jobs along with caring for my daughter. The time is always a little disconcerting without the steady pendulum effect of classes and assignments. Last summer I spent most of my time just getting over the mind-blowing effect of learning about Chinese culture and symbolism. I couldn’t tell you in any way what kind of medicine I would like to practice at that point. This summer is disconcerting in a new way. I find that the kind of doctor I want to be is becoming too broad! I want to treat everyone for everything!
Trying to narrow this down has led me to consider the “scope of practice” for Chinese medicine. In Oregon we have a Board of Medical Examiners defined Scope of Practice:
77.757 Definitions for ORS 677.757 to 677.770. As used in ORS 677.757 to 677.770 (current as of 2005, I don’t think any major revisions have been made, but I’m looking into it):
(1)(a) “Acupuncture” means an Oriental health care practice used to promote health and to treat neurological, organic or functional disorders by the stimulation of specific points on the surface of the body by the insertion of needles. “Acupuncture” includes the treatment method of moxibustion, as well as the use of electrical, thermal, mechanical or magnetic devices, with or without needles, to stimulate acupuncture points and acupuncture meridians and to induce acupuncture anesthesia or analgesia.(b) The practice of acupuncture also includes the following modalities as authorized by the Board of Medical Examiners for the State of Oregon:
(A) Traditional and modern techniques of diagnosis and evaluation;
(B) Oriental massage, exercise and related therapeutic methods; and
(C) The use of Oriental pharmacopoeia, vitamins, minerals and dietary advice.
(2) “Oriental pharmacopoeia” means a list of herbs described in traditional Oriental texts commonly used in accredited schools of Oriental medicine if the texts are approved by the Board of Medical Examiners for the State of Oregon. [1993 c.378 §1]
There is another section of interest – 677.190, section (9). It explains that a physician’s license can be revoked because of “unprofessional conduct” if the doctor is found to be, “Making statements that the licensee knows, or with the exercise of reasonable care should know, are false or misleading, regarding skill or the efficacy or value of the medicine, treatment or remedy prescribed or administered by the licensee or at the direction of the licensee in the treatment of any disease or other condition of the human body or mind.”
This is interesting given that earlier in the statutes it is explained that,
(b) For purposes of this subsection, the use of an alternative medical treatment shall not by itself constitute unprofessional conduct. For purposes of this paragraph:
(A) “Alternative medical treatment” means:
(i) A treatment that the treating physician, based on the physician’s professional experience, has an objective basis to believe has a reasonable probability for effectiveness in its intended use even if the treatment is outside recognized scientific guidelines, is unproven, is no longer used as a generally recognized or standard treatment or lacks the approval of the United States Food and Drug Administration;
(ii) A treatment that is supported for specific usages or outcomes by at least one other physician licensed by the Board of Medical Examiners; and
(iii) A treatment that poses no greater risk to a patient than the generally recognized or standard treatment.
So, despite the fact that some treatments may not be FDA approved or may not be within contemporary Western scientific guidelines they do not constitute unprofessional conduct, and thus cannot be said to violate the statute that recommends dismissal for licensed CM docs claiming that their medicine can treat conditions if such claims are supported by the medical philosophy under which they operate. OK. What does this mean for me?
Many people talk about the effectiveness of Chinese medicine for pain. The general public has also begun to understand that Chinese medicine is good for a few chronic conditions, including infertility. However, Chinese medicine is capable of much more than this. It is effective in treating acute stages of many illnesses, including febrile diseases, the common cold, trauma and even more life threatening conditions. One needs only to find an excellent practitioner with experience in this realm.
To provide an example, my daughter came down with something during the winter that involved an extremely high fever, sinus congestion and extreme throat pain – to the point where she couldn’t swallow. You’re all thinking strep throat, right? Well, me too. I wrestled with the thing for a while – just giving her fluids, keeping her cooled down. However, she wasn’t eating and her fever wasn’t breaking and I know better than to try to break the fever with over the counter medications. I debated taking her to urgent care (Western) or to my school’s clinic. It was difficult because even as committed to Chinese medicine as I am, I still have a lot of embedded beliefs that make me pause. I decided that I had to give it a shot. I took her to the clinic in the early evening and she was given acupuncture and an herbal formula. The formula was meant to be taken at a high frequency – we followed the instructions perfectly. The next morning she awoke with no fever, no sore throat, no sinus congestion and – most important – good energy and a smile on her face.
This isn’t an isolated incident. A well trained CM doctor can take care of any medical situation that comes up, save transplant situations or some similar condition that requires surgery. It may be a little fringe to suggest this is the case, but it has been my experience and the experience of many people I know personally.
Eric
Tags: Personal Development, scope-of-practice, law, Acute conditions, Acupuncture
{ 4 comments… read them below or add one }
Hi Eric,
So you mentioned that you’re not sure what kind of Dr you want to be. Are you thinking of going into some sort of specialty? Right now I’m very interested in fertility and women’s wellness, but then also I don’t want to miss out on gaining experience in other areas. And I haven’t even started school yet!
Katrina
Well, everything I’ve learned indicates that it’s best to go into some kind of specialty. In Portland, general practitioners of Chinese medicine are kind of a dime a dozen. Plus it helps you focus your education.
A caveat – you should always learn the basics as broadly as possible and shouldn’t be ignorant of any part of the medicine… of course.
I have a strong interest in psychological/emotional health, so I’ll definitely be focusing on that to some degree. I’m really interested in helping people with more common problems, though – daily stuff like colds/flus, injuries, insomnia… just the everyday experiences of the average person. I also have close involvement with the LGBT community and have a strong interest in transgender/transsexual health (such an underserved population!) so I may work on that as well. You can see I haven’t narrowed it down yet!
Fertility and women’s health is a GREAT speciality – so many seminar opportunities and people are learning more and more that Chinese medicine can help them in these areas. I’ll look forward to seeing how your ideas grow and change!
Eric
Wow, that’s great. I agree that the trans community is very underserviced. I can think of only two organizations here in Toronto that makes an effort to include this population.
I too am interested in the everyday complaints of the average person. I find that these sorts of ailments are the things that Western medicine has had little or zero success in.
funny, i’ve never associated tcm with pain. i use it to deal with smaller ailments… discomfort.