If we look where we’ve been since the 1970s, Chinese medicine in the USA has come a long way. The number of acupuncturists and schools has grown dramatically. Many people now entering the field look at Chinese medicine as a career, in contrast to earlier generations who primarily saw acupuncture and herbs as a lifestyle or an avocation.
On one hand, the future is very bright. Acupuncture and herbs can help many people who have not been able to be healed with allopathic medicine. Traditional Chinese medicine (TCM) is beginning to make inroads in hospital settings, as well as mainstream institutions. Millions of patients have been served. While many in the medical profession do not see competition with acupuncture, these same doctors view Chinese herbal medicine more suspiciously. There is pressure on Chinese herbs, due to prevalence of drugs in herbal products made in Asia, serious adulteration issues from products originating in China including: tainted milk, pet food, toys, and heparin. Fewer herbs are available due to endangered species issues, and more is known about herbs with potential toxicity, as screen methods are more exact. Banning of ingredients (ma-huang) and media bias are additional factors in limiting the acceptance of Chinese herbs. Medical journals and mainstream media publish negative articles on herbs much more readily than positive ones. The cost of Chinese herbs is rising due to inflation, added transportation costs, and higher demand for herbs in the PRC (People’s Republic of China). Increased costs will mean that we will need to carefully screen for substitutions, and we need to make sure our herbs will perform as expected. Higher prices will mean that patients will be looking for specific outcomes, not just balancing treatments.
If practitioners want continual access to Chinese herbs, we will have to think differently and training will need to improve. A first step would be to make sure that instructors of Chinese herbal medicine become familiar with the basics of herbal regulations, quality control issues, and how to run an herbal dispensary. (At a recent presentation I gave at an acupuncture school, not one student was familiar with current labeling requirements and good manufacturing practices but also to promote medicine as a whole. I have been involved in both formal double blind placebo controlled research as well as, more informal observational studies. For a number of reasons, I believe that each practitioner wanting to use herbs for the next ten years needs to think of the following: How could I set up a research study that honors TCM? With whom could I collaborate? What subject am I most interested in evaluating: A symptom or disease, and aspect of pattern differentiation, a formula or an herb?
Finally and most importantly, how can Chinese medicine garner ten times more positive publicity than it is now receiving? When Chinese herbs were facing extinction in the early 1990s, only a few individuals in the acupuncture and Chinatown communities took interest. At that time, the FDA proposed regulations that would have severely limited the sale of vitamins, nutritional supplements, and herbs, without prior approval. What this would have meant is that practically all Chinese herbs and formulas would have been subjected to animal or human safety studies. I was one of about one hundred people who worked full or part time, at no pay, for several years to save herbs.
Volunteers such as myself held rallies, printed and disseminated information, organized meetings with elected officials, and contacted media. In addition, thousands of people donated money, and millions of people wrote letters to politicians. The result was DSHEA (Dietary Supplement Health and Education Act), which saved Chinese herbs. How could you generate publicity for yourself and the profession? Besides writing articles, speaking in front of groups, and communicating with your patients, what could you do?
As most of our clients can only afford once a week appointments, I don’t think we can rely only on acupuncture. Even if we aren’t primarily an herbalist, herbs help sustain treatments, and help relieve symptoms that are poorly resolved with acupuncture alone. In China, herbalist are doctors, whereas acupuncturists are technicians. By combining both modalities, we are honoring tradition in service to patients.
All of us are busy. Most of us would prefer that the other person do the work. If we take no action, it is likely that acupuncture will continue, but herbs will be increasingly subject to bad publicity, increased regulation, and misinformation. It is time to get out in the world and help your practice and the profession.
Andrew Gaeddert is the president and founder of Health Concerns. He can be reached at: herbalist@healthconcerns.com.
Reprinted from CJOM – CaliforniaState Oriental Medical Association – 11/2010