March 13, 2013
Acupuncture Today reported big news for one of the largest medical schools in the United States. The University of California Los Angeles (UCLA) Health System has begun to introduce methods of Eastern medicine into their medical curriculum. Journalist Daniel Ramirez reports that “by meshing a 3,000-year-old medicine with cutting-edge medical science, one of the largest medical institutions in California is hoping to lead the way by proving there are effective ways to deal with disease with a new type of care that incorporates both East and West.” This was an exciting development for proponents of integrative health who believe that the more options available for patients, the better.
Now, over 500 UCLA physicians refer outpatients with chronic illnesses including rheumatology, neurology, and oncology to the East-West Clinic, where patients can be treated with acupuncture, Asian Bodywork, and Chinese herbology. "We are trying to move away from the disease-based model, and look at how Chinese medicine treats the whole patient," said East-West founder Ka-Kit Hui, M.D.
On the reverse side, Eastern medical institution Pacific College of Oriental Medicine (PCOM) has implemented an integrative approach for years. With three campuses across the United States (San Diego, Chicago, and New York), PCOM has incorporated core classes that provide students a working knowledge of Western biomedicine. Each campus has also collaborated with local hospitals and health centers in its respective city to offer students hands-on externship opportunities as they earn their degrees. According to PCOM San Diego Academic Dean Bob Damone, “We firmly believe that to meet the needs of patients, all physicians of East Asian medicine must not only be armed with the best tools this ancient tradition has to offer, but must also have a working knowledge of modern biomedicine.” Thus, Pacific College strives to retain the integrity of Chinese medicine while also enabling its students to effectively communicate and practice traditional Chinese medicine (TCM) in the Western world.
The benefits of having Western knowledge in addition to a thorough TCM education are numerous for both acupuncturists and massage therapists.
“Our grads are going into integrative medical environments in which patient care will be shared with biomedicine practitioners, therefore, inter-professional education, especially a solid foundation in biomedicine, is a very important aspect of our Chinese medicine programs,” says Dr. Belinda Anderson, Academic Dean and Research Director at PCOM New York, PhD, LAc. Oriental medicine practitioners specialize in Eastern holistic care, but their patients live in a Western world. Modern acupuncturists in the West will encounter many daily examples in which a knowledge of biomedicine and Western healthcare is crucial to maintain an efficient, communicative practice.
Gretchen Seitz, LAc, MSTOM is nationally board certified, and is an alumna of PCOM as well as a faculty member and actively practicing acupuncturist. “I feel the value of the Western portion of my education the most in my clinical practice in Bankers Hill,” Seitz says. “The patients that come in, most already have a Western diagnosis. Understanding that and how to communicate with them about their existing diagnosis is significant,” Seitz explains. Essentially, Seitz says that the background she has in Western medicine allows her to not only understand her patients’ medical history more clearly, but also enables her to effectively talk to the patient in the terms he or she best understands.
“Not to mention being able to communicate with my patients’ doctors and insurance carriers in the language they use…When I can write a report for an insurance company or an attorney on a personal injury case, and I can write it in a way that demonstrates a strong Western background, it immediately establishes a level of credibility,” Seitz says. She adds that getting paid by insurance companies demands effective communication in Western medical language as well. Angela Yvonne, LAc, MSTOM practices acupuncture in La Jolla, California and works closely with Western endocrinologists for her patients with fertility issues. Yvonne says, “When working with fertility patients, you work with a lot of different medications—especially when helping with in vitro fertilization (IVF). Your patients are coming to you for complementary care for a Western treatment that may involve many medications. It’s essential that I understand what each of those medications are, as well as hormone levels, etc.” As an acupuncturist, Yvonne may see things in a different light than a patients’ specialist, but with her knowledge of Western medicine, she can effectively communicate and act on her suggestions. “A lot of times I’m the one to recommend a blood test. Being able to read and understand results like that is integral to my practice,” Yvonne says.
Jason Rogers, LAc, MSTOM is an acupuncture practitioner in San Diego. Rogers views Western medical terminology as a bridge for TCM practitioners to help Western minds better understand Eastern medicine. “We do grow up in a Western world,” Rogers notes. “A lot of times, the terms we use for organs and diseases are foreign to our patients. It’s nice to be able to relate it to something they know. I’ve found it helpful to start from a Western perspective when explaining a health issue to a client.”
Patients aren’t the only Western minds who benefit from an acupuncturist having a command of contemporary medical language. “When I’ve worked with people from a Western point of view, like pharmacists or nurses, I can explain to them my end goal in a way they understand,” Rogers says. A good example of this is when Rogers was working with a pharmacist on behalf of a patient and needed to explain that the core issue he wanted to improve was the patient’s blood circulation. He used familiar terms like this to explain his goal, rather than referring to it as “moving qi and blood”, which is the TCM phrase.
Yvonne agrees with the importance of collaborating with her patients’ other healthcare providers (not a fan of this description), whether they are doctors, nurses, pharmacists, or insurance carriers. She takes this a step further and points out how Western medical research can help narrow down which TCM treatment plan to implement for a specific patient. Yvonne says, “You can have a TCM diagnosis that has five different treatment paths, perhaps it’s different herbal formulas or acupuncture points to target. Western research can sometimes help determine which TCM treatment is the strongest option for that particular patient’s case.” An example of this is recent research on the strength of various herbs used frequently in Chinese herbology.
When combined with Yvonne’s knowledge of what kind of medications her patient may already be taking, she can most effectively pinpoint which treatment plan to suggest. Brendan Mattson, Director of Education at the Chicago campus, works mainly with cancer patients in his practice and therefore also works with closely with biomedicine and medical doctors on his patients’ cases. Mattson says, “We have a responsibility to our patients to help them understand the wide range of health advice they receive from various sources, including their own personal research on the internet. People are inundated with information about supplements and natural therapies when they are diagnosed with an illness. We see it as part of our mission to help them separate the fads from the well-researched treatment options. Pacific grads are exceptionally well prepared to do this for their patients, and they incorporate acupuncture, herbs, and bodywork with a strong understanding of how this fits in to an overall treatment plan with multiple practitioners.”
Acupuncturists aren’t the only East Asian medical practitioners to benefit from an understanding of their Western counterparts. Massage therapists who have mastered Asian Bodywork are in a prime position to give quality care when they are versed in Western medicine basics as well. Deb Reuss, the Dean of Asian Holistic Health and Massage at Pacific College, San Diego puts it clearly when she says, “You need to understand your sciences in order to know what you’re touching and working on.” From a massage perspective, there is more opportunity to offer truly therapeutic work when you understand the body on a deeper, more scientific level. Reuss provides some specific examples of when involved education of the body is absolutely necessary for a massage, “Perinatal Massage is an excellent example of this. This is a class we offer that focuses exclusively on how to work on pregnant women between the first term through delivery, and how to safely give them a massage.” Other examples include the areas of orthopedic massage and traumatology.
A massage therapist must have a complex understanding of the Western diagnosis of muscle injury and how to treat it in order to perform a massage on a patient recovering from a serious injury. Damone adds, “The orthopedic and neurology classes are Western, and one reason behind this is to make sure our students are really good at treating pain from an integrative approach.” Students at Pacific College also have the opportunity to be introduced to kinesiology and biomechanics (how one walks, body structure, etc.) in the massage program.
Often, Western classes at Pacific College are paired with a TCM class that mirrors the subject. For example, the Orthopedic Assessment class focuses on Western muscle and structure study, and is an excellent pairing with the Sports Tui Na class, which explores Asian Bodywork modalities for those same kinds of muscle issues. Reuss feels that the more Western background a massage alumna has, the more opportunity there is to secure competitive positions in the industry. She is looking to expand to create a lymphatic drainage class at Pacific College, San Diego, which she says, “would open doors for massage therapists to work with more cancer patients and post-surgery and trauma patients in hospitals and private practices.” This class would introduce ways to help reduce inflammation and increase healing in these kinds of patients. The proposed lymphatic drainage class would serve as the Western mirror to the current Eastern perspective class Tui Na Treatment of Internal Disharmonies.
Perhaps one of the most exciting aspects of the growing interest in Eastern medicine at Western schools such as UCLA, and at Western health centers like Scripps and the UCSD clinic in San Diego, is the prospect of Western physicians becoming open to referrals. Referring their patients to acupuncturists and massage therapists can lead to a true integration of Eastern and Western medicine. And it’s something that acupuncturists want to be able to do as well.
Damone states, “There have been patients I’ve had to convince needed more than me. I had to know my limitations. The Hippocratic Oath states ‘do no harm’.” When most people hear this mantra, they think it relates to doing harm by action, but it can also mean inflicting harm by inaction. Damone adds, “If you need to refer out, it does not make you a bad practitioner. It can make you a stronger one.” For example, if you have a patient with stage one melanoma, no practitioner would recommend the patient stick to only using one method of treatment. Their best path to health may involve surgery or chemotherapy in addition to acupuncture and herbology.
Students and alumni of Pacific College are able to build their connections to other types of healthcare providers by attending PCOM networking events such as “Business & Bagels” and the “Integrative Medical Discussion Group,” both of which include practitioners from all walks of medicine. Damone puts it best, “You need to know what your patients need, and having a solid foundation in Western care will enable you to give them the best care possible.”
Acupuncturists and massage therapists are passionate about healing. Pacific College is honored to train and introduce holistic healers into a growing industry that is fast becoming more open to integrative care. Seitz embraces her path and the background that has enabled her to help so many, “I love everything about what I do and it’s important for everyone to communicate on the same level about it. We are very educated people and I think the general public is increasingly beginning to be able to understand that.” With a foundation in Western medicine and terminology, the mind, body, and spirit healing of East Asian medicine has never before been so present in the West.
Ramirez, Daniel, East Meets Best at UCLA, Acupuncture Today, February 2013