I was encouraged when the World Health Organization (WHO) announced last year that it would include Traditional Chinese Medicine (TCM) in the upcoming edition of the International Statistical Classification of Diseases and Related Health Problems (ICD), a hugely influential compendium used by health practitioners around the globe. I believe doing so will help build awareness of a broader range of treatment alternatives that can address individuals’ conditions more comprehensively.
However, some medical professionals think otherwise. This CNN article “Some European doctors think Chinese medicine should come with a health warning” lays out a case against this move by the WHO.
The article argues that this move creates a “risk in misleading patients and doctors and increasing pressures for reimbursement by public health systems at a time of limited resources.” It got me thinking about my own Chinese medical practice and medicine in general, and I’d like to refute some of the author’s points below.
Complementary versus Alternative Medicine
One of the author’s main qualms with this move seems to be that if TCM is validated by the WHO, then patients with life-threatening or debilitating diseases like Parkinson’s or cancer will seek TCM treatment in place of modern Western medicine practices. It really takes a negligent acupuncturist or Chinese medical provider here in the U.S. to try to ‘treat’ either condition without the patient also being in the care of an oncologist or neurologist. I wouldn’t, partly because my malpractice wouldn’t cover it, and more importantly, it is unethical!
For major diseases and illnesses where scientific data shows that modern Western medicine works, I see TCM as a supplement to, not a substitute for Western medicine. TCM can be extremely helpful in reducing the side effects of chemotherapy, for instance.
And of course, a lot of my fertility work with patients is as a supplement to assisted reproductive technology (ART) treatment and other Western medical fertility approaches. I am always verifying medical files and making the appropriate referral for further testing so that I can provide the most appropriate, quality care. I (and my fellow professionally trained American Board of Oriental Reproductive Medicine (ABORM) colleagues) often refer out to a reproductive endocrinologist when we believe conventional fertility treatment is necessary or will be faster.
I am very much aware of Chinese medicine’s limitations and the diseases that require a physician’s training and expertise before treatment would ever (if ever) commence with me. At the same time, I believe there are instances where TCM can be a first line or standalone treatment.
When TCM can be a standalone treatment and decrease public health system costs
During cold and flu season, many of my colleagues remark on the high number of patients they’ve seen for intractable sinus pressure, cough and congestion, all starting with a common cold or flu that didn’t quit. I can say with utmost confidence that an appropriately timed acupuncture session and course of Chinese herbs at the beginning of the cold or flu would’ve drastically reduced further complicating symptoms. There would’ve likely been no bronchitis, no sinus infection, less work missed, no antibiotics, and fewer healthcare costs from hospital visits (if any). This would arguably decrease the reimbursement costs of public health systems, which is the opposite of what the author says including TCM in the ICD would do.
TCM (and other alternative modalities) have consistently demonstrated improvements regulating the female reproductive system/cycle and chronic health issues that Western medicine has little effect on. Western medicine has not been able to address the root cause of so much chronic pain and instead just medicates, often causing other major health problems that I won’t even get into (ahem, opioid epidemic).
Having been a practitioner of Chinese medicine for 15 years, I recognize the medical conditions that respond more effectively to Chinese medicine versus allopathic medicine.
TCM is difficult to validate
The article also makes the point that TCM is not scientifically validated, but I’d like to make a couple of counterpoints. Firstly, many of Western medicine’s practices are not scientifically validated. For instance, many studies show that antidepressants work no better than a placebo. And yet, doctors are prescribing antidepressants (many with unpleasant or damaging side effects) at ever-increasing rates.
Furthermore, it is incredibly difficult to design and perform scientifically rigorous studies showing the validity of TCM for these reasons:
- Chinese herbal formulas are prescribed differently than western herbalism and conventional pharmaceuticals. A Chinese herbal formula contains numerous herbs with varying dosages that work together to address a Chinese medical pattern identified by the practitioner. The Western approach often uses one or two herbs or medications to treat a specific symptom or diagnosis. It’s extremely difficult to study 10 to 15 herbs, which usually comprise a Chinese herbal formula, for a constellation of symptoms, which is what the practitioner identifies to make a Chinese medical diagnosis.
- As mentioned above, a Chinese herbal formula requires a Chinese medical diagnosis, which always accounts for more than one symptom. Then an appropriate herbal formula is often modified to best address the Chinese medical diagnosis. For example, two individuals could have the same diagnosis but the herbal ratios in their formula often varies, making it extremely difficult to study how individual herbs act in a formula, given each herb has a dosing range.
Extreme examples of TCM are misleading
Finally, the author’s examples of Chinese herbs are extreme or inaccurate. He uses the example of “Black Salve” – which isn’t even a Chinese herb, or Chinese herbalism, by the way – to show harm done by false claims within social media platforms. The references to “tiger penis,” a medicinal that while tragically is still used in parts of China, is banned in other parts of the world. In reality, TCM is actually practiced with a great deal of caution and care by the vast majority of practitioners.
I understand his concern that social media amplifies and spreads false claims about Chinese medicine; however, the same could be said about just about any medicine (or anything, for that matter). For every piece of misleading and potentially harmful advice about TCM on the internet, you can find heaps of misleading and potentially harmful advice for general medical care.
Most TCM practitioners do not give general advice on social media or other platforms about how to treat themselves. In fact, it is a very individualized approach, moreso than Western medicine certainly. The bottom line, however, is that people seeking healthcare advice should consult a qualified, trained professional, TCM or otherwise.
Maybe all healthcare should come with a health warning
So, in circling back to the original question – “Should Chinese Medicine come with a health warning?” – I would say that it should come with an explanation of realistic expectations of what it can and can’t do. I would say the same things for any and all healthcare.
Maybe the best practice at times is to educate patients on a range of safe modalities that may help them. Maybe legitimizing TCM and other ‘alternative’ medicines will help more healthcare practitioners understand the strengths and limitations of more treatments, and help more patients feel better, and stay better.