Traditional Chinese medicine adoption and patient care accessibility

Chinese Medicine Impact on Patient Care

One may perceive traditional Chinese medicine (TCM), employed in Southeast Asian nations such as China, Japan, Korea etc., as a key CAM (complementary and alternative medicine) element. TCM in the field of therapy has been winning immense popularity worldwide, since decades. It can be regarded as one of human society's most priceless treasures; TCM practice is constantly improved through extensive hands-on experience in therapy and wellness maintenance. The UNESCO (United Nations Educational, Scientific and Cultural Organization) has, as a matter of fact, included moxibustion and acupuncture in the Representative List of the Intangible Cultural Heritage of Humanity in 2010 (Zhang, Kong, Zhang & Li, 2012).

Introduction- Reasons for wide acceptability

The May 2009 World Health Assembly Resolution on Traditional Medicine (WHA 62.13), owing to its extensive contribution and history in healthcare, encouraged all WHO member countries to formulate policies for integrating traditional therapies into their health systems. For offering member nations the requisite technical and policy-related assistance, a number of workshops were planned by the WHO, on healthcare delivery and traditional medicine monitoring (Zhang et al., 2012).

TCAM (short for traditional/CAM) owes its extensive usage to high levels of per capita TCAM-practitioner distribution in developing nations. Examples cited in a WHO report, of Tanzania, Uganda, and Zambia, reveal population-healer ratio to be 1:200-1:400 in the countries; on the other hand, allopathic physician-population ratio is 1:20,000. Indian government reports indicate that TCAM constitutes the only obtainable healthcare for 65% of citizens (WHO 2002: 13). In several nations, TCAM also denotes a healthcare source that is within people's means. Another cause for its extensive usage is its firm entrenchment in cultural belief systems, thereby becoming culturally compatible. Patients in developed nations prefer TCAM principally because of higher education/income factors. Because of obstacles to mainstream health service access, developed countries' ethnic minorities (being socially as well as economically disadvantaged), give priority to TCAM for healthcare, rendering the practice non-complementary (Bodeker, Kronenberg and Burford, 2007b).

Rise in chronic illnesses, knowledge regarding modern medicine's limitations, evidence of TCAM effectiveness in certain conditions, integrated medical education, growing interest in all-round preventive health, and greater awareness among healthcare providers have rekindled interest in TCAM. TCAM practitioners' higher care quality also marks a significant reason for its increased demand and patient satisfaction.

Divergent reasons can be viewed among developing nations' urban and rural trends with regard to seeking healthcare services. Cost, accessibility, and availability are key factors in rural regions, whereas modern medicine limitations, concerns regarding chemical drugs, allopathic treatment's questionable assumptions, shifting values, decreased acceptance of paternalism, ecological awareness, fitness etc., and increased public information access are the factors leading to urban regions' and developed nations' adoption of TCAM (WHO 2002: 14). Therefore, in India, China and other emerging economies, characterized by a large variance between rural and urban regions, the effect of proactive TCAM policies will be felt across the nation (Bodeker et al., 2007b; Liu, Chuang, Lam, Jiang & Cheng, 2015).

Traditional Chinese medicine and western medicine

Physicians of Western medicine and TCM practitioners are known to collaborate effectively within China, particularly in the ethno-medicine field. The sphere of herbal Chinese medicine utilizes several compounds unfamiliar to Western medicine; keen interest has been currently undertaken in regard to these compounds, in addition to TCM theories employed for deducing the compound to be prescribed for individual patients. Advanced traditional-medicine practitioners in the country are conversely drawn to experimental and statistical methods that may aid them in better differentiating between medicines that work and those that are ineffective in a particular case for a particular individual. One of the outcomes of such collaboration is the development of medical databases and scientific, peer-reviewed journals on TCM (Payyappallimana, 2009).

Western countries depict a more combative allopathic-TCM relationship. Though an increasing number of medical colleges are integrating CAM classes into their syllabi, old, traditionalist Western scholars and physicians are a lot more likely (compared to Chinese practitioners), to have a cynical outlook towards TCM, considering it superstitious and an obsolete pseudo-scientific field. There are numerous reasons for this suspicion. Firstly, in the Western world, TCM is primarily promoted either by migrants from China or by individuals who, after their experience with modern medicine, have lost their trust in it and seek an alternative treatment source. Several individuals in Western countries stereotypically believe the East to be unscientific and mystical, thus attracting only those who have given up hope on scientific aid, whilst repelling individuals who live by scientific principles. The West has also seen its fair share of deceitful or well-intentioned but inadequately-trained traditional practitioners who, in several cases, have done more damage to existing issues of people (Payyappallimana, 2009; Patwardhan, 2005).

A good explanation that highlights the differences in TCM's role in Western countries and China would be that of an individual from the developed world region would probably never approach a school of martial arts or a TCM practitioner for fixing a broken nose (a straightforward, regular condition); in China; however, this is what is commonly done. An example of the other kind would be that a majority of Chinese TCM hospitals keep electron microscopes, with numerous practitioners trained in their operation (Payyappallimana, 2009).

The aforementioned examples, however, do not allude that the Western world regards TCM techniques as being entirely worthless. Pharmaceutical firms in the West have, as a matter of fact, realized the worth of TCAM, and are now hiring teams of researchers across the globe for gathering information from healers and TCAM practitioners. In any case, animals or plants were the source of conventional drugs' active ingredients. Modern medicine's specific contribution is its rigorous application of scientific methodology to traditional treatments with potential, segregating effective medicines from ineffective ones. Another example is: a majority of Western hospitals/clinics are now providing qigong or T'ai Chi Ch'uan classes under their community and inpatient health interventions (Payyappallimana, 2009; Bodeker et al., 2007b).

In China, the majority of citizens don't perceive any conflict between Western medicine and TCM. In emergency situations and crises, people often resort to conventional medicine without hesitation. Concurrently, their faith in TCM's ability to maintain health remains strong (Bodeker et al., 2007b). In simple terms, they will visit conventional physicians for treating acute appendicitis; however, when it comes to appendicitis prevention or speedy recovery post-surgery, they tend to rely more on Chinese medicine and exercises. Conventional-medicine practitioners in China seldom reject TCM, and a majority of them incorporate its components in their regular practice (Payyappallimana, 2009).

Issues Facing TCM

TCM -- collected, evolved, and developed through millennia of practice -- has guaranteed China's descent and contributed a priceless school of medicine to the entire world. It cannot, however, be denied that TCM's progress has been scant, with its application progressively dwindling in the twentieth century's latter decades. Thus, it is imperative to investigate all challenges posed to TCM and take into account possible solutions to these issues, towards accruing any appreciable adaptation of its theories and practice (Patwardhan, 2005).

Inappropriate regulations and policies developed by the government for TCM-administration undermine TCM's value and theory. Experts and governmental authorities normally regard TCM as an out-dated technique, owing to its ancient, untraceable roots. The field is also deemed as unscientific, due to incompatibility with the modern science; also, incapability of modern science to account for a number of TCM theories. Consequently, authorities administer TCM as per experience gleaned from conventional medicine, while encouraging research and development of TCM via brainstorming and direct research of conventional medicine. TCM's regulation and intrinsic characteristic are largely overlooked; further, some laws and regulations have restricted TCM (Shaw, 2010).

National policy misdirection has caused a gradual loss in TCM's clinical advantages and characteristics. For several years, the focus of studies on TCM has mostly been governmental evaluation standards and preferential, biased treatment by some authorities. Evaluating TCM's value is quite challenging, owing to an absence of practical benchmarks suited to TCM characteristics, to assess its safety and effectiveness. Ironically, modern medicine and science plays the role of "gold standard" in TCM evaluation, directing its development. No independent standards and norms provide for TCM safety and effectiveness research, for long. Moreover, everybody in developed and influenced world is prone to adhering to conventional medicine's rules. TCM development is influenced by regulatory concerns raised by conventional medicine (Payyappallimana, 2009; Shaw, 2010).

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First of all, current statistical evidence and assessment techniques are ineffective in portraying TCM's worth. Numerous individual cases reported among TCM books appeared impossible to repeat and approve. Furthermore, general statistics of conventional medicine do not provide describable guidelines of the proper use of TCM, and well-established evidences of its effectiveness. However, some specialists in the TCM field believe such outcomes to be expected, as TCM constantly demonstrates repetitions, through repetitive application in accordance with TCM syndromes rather than diseases. The rules of TCM syndrome-based therapy can be wholly repeated, although repetition of a medication/prescription may prove difficult. Patients sharing identical, main TCM syndromes can be prescribed nearly-identical medicine, despite suffering from entirely different diseases (such as arthritis and hypertension) (Shaw, 2010). That explains why TCM can descend from one generation to another; otherwise, it would not carry forward and spread extensively, nor would it have been learnt by posterity.