Understanding TCM

There is an unfair amount of bashing of the TCM paradigm both in China and the west by traditionalists. TCM is still operating from the foundation theories of Chinese medicine, i.e. Yin-Yang, Five Elements, the Shang Han Lun, etc. The dominant treatment modalities are still herbs, acupuncture and bodywork. As the dominant force of Chinese medicine in China, they also have incredible resources in the form of hospitals, schools and research. Everyday, hundreds of thousands of Chinese are treated with Chinese medicine under this paradigm, and many experience excellent results.

Though I am personally as traditional as one can be in this medicine, I have come to view “TCM” as another style or lineage of practice within the greater history of Chinese medicine. It is has a specific personality, it approaches illnesses in a certain way, and it does have much to offer the sick. That there are many practitioners of this paradigm who have very poor clinical skills, that there are many TCM hospitals that look more like factories and treat patients more like meat instead of humans is a reality. But there are also very skilled, caring practitioners at work within the paradigm, and institutions that are doing their best to help the masses. It is simply a question of finding those practitioners and hospitals, and not the large number of uncaring situations that many westerners equate with all of Chinese medicine in China.

To understand this dichotomy, it is important to remember that there are between 1 and 2 billion people in China. Health care for the masses is still young and developing. At this time in history, there is a greater focus on getting some kind of health care out there regardless of quality, than focusing on only having high quality institutions. The efforts under Communism to re-educate the masses into a certain thinking pattern and the thinking pattern that arose out of living under Communism has also greatly affected the personalities of TCM institutions, its administrators and doctors. To someone who does not understand the history of the country and doesn’t have the time or skills to uncover the good within all of this, it is easy to claim that, “Traditional Chinese medicine no longer exists in China.” It is, however, patently untrue.

Understanding Hospital Rankings

Hospitals are ranked in levels. A level 1 hospital is flat out forbidden to have or treat westerners. These are not where you would ever want to find yourself for any type of training or health concern.

Level 2 hospitals are where most training programs for westerners happen. For the most part, while the doctors might have been practicing for decades, they are not exceptionally well trained, nor are practicing at a very high level of medicine. The hospital is western medicine focused with a wing, ward or room featuring acupuncture as an adjunct therapy. Despite having a large volume of patients per day, the majority suffer from the same diseases: stroke, Bell’s Palsy, backache, and old age. The advantage of these hospitals is that patients are literally paying between ten cents and a dollar per treatment, so they have little say on whether they are needled by a doctor or a training westerner. This has made this level of hospital the ideal place for Chinese organizations to run training programs for westerners. Level 2 hospitals feature little or no herbal prescriptions, relying on patent medicine if anything at all.

Level 3 hospitals often have teaching departments and feature a greater integration of acupuncture and herbs within the western medical setting. Doctors often have good clinical experience, but for the most part do not come from the best schools or internships in the country. As patients are paying more, they expect treatment from an expert. Western practitioners must demonstrate a certain level of skill in free hand needling and finding the Qi before being able to work on patients.

Top level hospitals, such as the Beijing Traditional Chinese Medicine Hospital, feature the very best teachers and practitioners of the TCM paradigm. They are highly skilled in discussing theory and application while treating patients, and their hospitals are Chinese medicine focused, with western medicine as the adjunct therapy. Again, patients are coming to these hospitals and paying more to be treated by experts. Western practitioners who are not skilled at Chinese needling will find themselves observing until they are deemed qualified or have the patient’s permission. This is less of an issue for the Tuina program and does not apply to the herbal training programs. The best training of herbal usage within the TCM paradigm is at the top level hospitals.