British Columbia aids the merger of traditional Chinese practice with western medicine
The Best of Both Worlds
British Columbia aids the merger of traditional Chinese practice with western medicine
At age 35, Vancouver lawyer Mason Loh faced the dismal prospect of a life wracked with pain or numbed by powerful medication. Inflamed joints from psoriatic arthritis left him feeling old and frail. “I’d wake up in the morning and the first thing I’d do is take a painkiller, otherwise I couldn’t even get out of bed. I couldn’t walk. I couldn’t even turn a door handle.” In desperation, Loh looked back some 4,000 years, to the traditional Chinese medicine of his ancestors. He tried acupuncture, herbal concoctions and finally meditative exercise known as qigong, which he credits with giving relief. Today, free of prescription painkillers for eight years, he easily closes his fist and rotates his arm, as though opening a door.
It’s an appropriate gesture. Loh, as volunteer chairman of the new regulatory College of Traditional Chinese Medicine Practitioners and Acupuncturists of British Columbia, is determined to expose the country to the benefits of the ancient healing art.
British Columbia is the first province in Canada to confer professional status—and responsibility—on all traditional Chinese medicine therapies. The college is circulating draft bylaws to set the educational standards and responsibilities for the province’s newest categories of medical professionals: acupuncturists and traditional Chinese herbalists, practitioners and doctors. The college will also require a prescription system for certain herbal formulas and impose disciplinary procedures for cases of malpractice, much like mainstream medical colleges.
More than 400 of an estimated total of between 600 and 1,000 acupuncturists in the province are already dues-paying members of the college. Once the province approves the standards for herbal and exer
cise therapists, likely later this year, college membership will jump to as much as 1,200.
The experiment could set a precedent for other provinces. Ontario is considering a similar move. Alberta and Quebec regulate acupuncture, but have not extended recognition to the full exotic sweep of Chinese therapies. Ontario and Alberta have passed laws allowing western-trained doctors to use alternative therapies. They are responding to a powerful trend: more than half of Canadians are now at least occasional users of Chinese medicine or a host of other herbal or homeopathic preparations, including echinacea for colds, ginkgo biloba for improved memory and ginseng as a tonic.
The yellow Telus Pages of the Vancouver phone book list almost five pages of acupuncturists, advertising treatments for ailments as diverse as chronic pain, hypertension, stress, addiction, arthritis and impotence. You’re nobody these days unless your yin and yang has been pincushioned back into balance and your body is stuffed with more herbs than the signature dish at a five-star restaurant. In certain circles it is considered polite conversation to comment on the colour of one’s tongue, that being a prime indicator of inner health. Apothecaries on the hectic streets of Vancouver’s Chinatown, and in the sleek Asian malls of neighbouring Richmond, are crowded with customers of all origins seeking comfort or cure from bins of gnarled roots and jars of fragrant herbal mixes.
For much of their long history in British Columbia, acupuncturists and herbalists worked on the leg gal fringes of medicine. Though enforcement has | long since relaxed, acupuncturists have been prosef cuted for practising medicine without a licence. I
Unable to charge for a medical diagnosis, Chinese practitioners often skirted regulations by offering “free” consultations in Chinatown herbal shops. Their pay was a cut of the cost of the prescribed herbal concoctions.
Randy Wong, registrar of the fledgling college, is a former hospital CEO with a master’s degree in health administration. He says traditional Chinese medicinerooted in disease prevention, low-tech treatment and beneficial exercises—is a more costeffective way of treating some ailments and chronic conditions than $500to $ 1,500-a-day hospital admissions. Wong prefers the term “complementary” to “alternative” medicine, saying the eastern and western schools of practice should co-operate rather than compete. “Patients should be able to pick and choose what is relevant and effective for them.” Western acute and emergency medicine is undeniably effective, he says. To a former administrator in the cash-starved B.C. hospital system, the $50 or $100 cost of visits to a herbalist or acupuncturist has great appeal. “If it works, do it,” he says. “And if it’s cheap, so much the better.”
If it works is still the issue in many western minds. Critics say there have been too few western-style double-blind, randomized, controlled studies to prove the efficacy of acupuncture, moxibustión (a heat treatment using burning herbs), herbal medicine, food therapy or the various schools of mas-
sage, exercise and meditative therapies like tai chi and qigong. They point to risks as well: infection or injury from acupuncture needles; misdiagnosis of serious illness; side effects from herbs that may be naturally toxic, contaminated or incompatible with prescription medicine.
Doctors have found cases of lead, mercury and arsenic poisoning among users of traditional medicines, and some adverse reactions when they are used with conventional medicine, says Toronto physician Mel Borins, who wrote a 1998 paper on the dangers of using herbs. Health Canada warned last week that two traditional medicines for children—Bao Ji Wan pills and Chinese Modular Solution chest relief tablets—are toxic and could cause “serious adverse health consequences or death.” British Columbia’s mainstream medical community raised public safety concerns when the Health Professions Council circulated its proposal to designate traditional Chinese medicine as a profession. The B.C. Medical Association urged deferring the decision until there has been a proper evaluation of its effectiveness. And the College of Physicians and Surgeons of British Columbia warned that extending the term “medicine” and “doctor” to traditional practitioners confuses the public.
Such concerns were the very reason for licensing and regulating the practice, says Alan Moyes, director of legislation and professional regulation for the provincial health ministry. The
governments objective, he says, is to protect the public, not to confer legitimacy on traditional Chinese medicine. “Its likely to continue to grow,” says Moyes, “and that’s part of the basis for the government’s decision to step in and establish a college to regulate practice.”
On a Friday afternoon in an examination room of the International College of Traditional Chinese Medicine of Vancouver, Rachel Dykerman, 20, is sticking out her tongue. The clinic at the 190-student teaching school, the largest in the province, gets a steady stream of patients offering up their bodies in exchange for a free consultation and treatment. For much of an hour, two lab-coated students and their teacher pepper Dykerman with questions about lifestyle, diet and bodily functions. One remarks on her tongue’s red tip. The colour of a tongue and any coating it has are considered key indicators of circulation and health. The students take turns reading her pulse, another major indicator of health. Their diagnosis: Dykerman has an energy and blood deficiency.
In a treatment room, the students insert a series of acupuncture needles. Those in the crook of Dykerman s arm are to reduce her body’s “heat.” Those in her legs treat stomach, spleen, liver and kidneys, to rectify blood disorder. It was curiosity more than illness that brought her to the clinic, she says. Western doctors can only benefit from thousands of years of eastern experience, she says. “It’s always good to get the best from everything,” adds Dykerman, “not to keep your blinders on.”
When Henry Lu, now 64, founded the school 16 years ago,
he elected to teach only in English, painstakingly translating many of the original Chinese-language texts himself. He approaches the task with evangelical zeal. “Traditional medicine to me is like medicare was to Tommy Douglas,” says Lu, who earned a PhD in education and philosophy from the University of Alberta before studying traditional medicine in China. “I didn’t think it was wise for Chinese medicine to be confined to Chinatown,” he says. Lu also serves with Loh on a nine-member advisory board for the new regulatory college, which he sees as an important step in the professions acceptance.
Mason Loh is married to Dr. Karmen Loh, a Vancouver family practitioner who graduated from the University of British Columbia medical school. With a doctor’s caution, she questions her husband’s claims that qigong meditative exercises “cured” his arthritis. She says, however, that qigong gave him “a new source of energy” and freed him from needing anti-inflammatory medication. Karmen Loh was raised in Vancouver in a traditional Chinese family and grew up drinking teas for flu, colds and her general health. She says her own patients are open about their use of complementary medicines, and doctors can’t ignore the trend. Loh concedes she does not understand how her husband was helped, but she is not surprised by the outcome. “So?” she demands. “There are lots of things we don’t understand.”
What has been your experience with complementary therapy?
WESTERN TRAINING, EASTERN LEARNING
Dr. Wah Jun Tze, just back in his Vancouver home from his 111 th trip to China, is determined to bridge a divide that often seems as wide as the Pacific. He has embarked on a crossCanada tour to promote his new book, Health Quotient, which advocates the marriage of conventional and natural medicine. Although Tze is a western-trained pediatrician, he considers conventional medicine too reliant on drugs and surgery.
He urges people to take responsibility for their own health, and to draw from the lessons of ancient Chinese
medicine and other age-old healing practices. They have long recognized that emotional and physical health are inextricably linked. Tze sees the growing interest in herbs, acupuncture and meditative and physical exercises like qigong and tai chi as a renewed appreciation “of your body’s innate power to heal itself.” Self-healing is not without work. Tze expects his readers to complete his 20-page inventory of their health status and their knowledge of health and other personal factors before setting out on a path to wellness and harmony. The book is only one facet of his campaign. Tze is chairman of an expert advisory panel to the federal health department’s new Natural Health Products Directorate. That is Ottawa’s attempt to ensure the safety and quality of the natural health products that the Canadian public is em-
bracing. Tze says his many trips to China have alleviated his own doubts, as a doctor and scientist, about ancient herbal medicines. “I’ve seen with my own eyes that they work,” he says.
Tze also helped found the Tzu Chi Institute for Complementary and Alternative Medicine in 1996. The centre, on the grounds of the giant Vancouver Hospital and Health Sciences Centre, attempts to integrate alternative medicine—the use of acupuncture in the treatment of multiple sclerosis, for example—into mainstream health care. Its stated aim is to win such acceptance that terms like “alternative medicine” fade away. For now, though, it remains a tiny outpost, surrounded by a bastion of western medicine preoccupied with bed shortages, wait-lists and its own budgetary ill-health.
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