The publication by the General Medical Council of its Good Medical Practice rules and guidance which received extensive coverage in the UK media, has highlighted the issue of patient-practitioner professional relationships and what is considered acceptable or unacceptable behaviour. The author of this article currently serves as the British Acupuncture Council's Professional Conduct Officer. She writes to alert practitioners to the genuine problems that exist in patient-practitioner relationships, and to prompt them to consider whether their conduct, and that of their patients, is within acceptable boundaries.
This article, written from the perspective of a Five-Element practitioner and teacher, begins with an account of his experience of the Fire element and its significance for him personally. It moves on to give the classical context of the author’s understanding of the Fire element, outlining the roles of the four Fire Officials (heart, small intestine, heart protector and three heater). The Five-Element approach to treatment is then illustrated using two vividly portrayed and sharply contrasting examples of patients with Causative Factors in the Fire element, addressing the diagnosis, treatment and outcome in each case. Read the whole article
Pillow Needles and C Scores as Reflections on Growing an Acupuncturist
Susanna Dowie EJOM Vol. 4 No. 2
This article is the author's exploration of what it means to be an acupuncturist, with reflections on how and why the profession has changed over the last 25 years, and the development of professionalism. The article examines how far an acupuncturist is born and how far they can be grown, with particular reference to the means whereby suitable students can be selected for training. Also considered are the roles of the therapeutic relationship in successful practice and that of continuing professional development in the never-ending journey towards mastery of Chinese medicine Read the whole article
The Inner Development of the Practitioner
Angela Hicks, John Hicks and Peter Mole EJOM Vol. 5 No. 1
This article is an extract from the book Five Element Constitutional Acupuncture. The authors point out that throughout the history of Chinese medicine, it has been understood that the individuality of the practitioner has an enormous effect on the efficacy of acupuncture treatment. They suggest that because the emphasis of Five Element Constitutional Acupuncture is on treating at the subtlest levels of the person’s qi, it is natural that many practitioners of this style of acupuncture place a great deal of importance on their internal state. A number of issues relating to inner development are discussed including, the practitioner’s inner state, focusing attention, intention, maximising rapport with the patient, compassion, empathy and cultivating linghuo or virtuosity.
The Role of Acupuncture in the Treatment of Cancer (Part 1)
Dr Friedrich Staebler EJOM Vol. 5 No. 1
This paper is written for acupuncturists to examine the challenges we are faced with when treating patients with cancer. It looks at what cancer is, both in the western and TCM paradigm, and examines the role of the emotions in the development of cancer. Questions are asked: What happens to patients when they are diagnosed with cancer? What are the treatment options? When are we, as acupuncturists, called upon and what is our role as carers and as acupuncturists? What can acupuncture and Chinese medicine contribute in the treatment of cancer, and where are the limitations? The aim of this paper is to encourage acupuncturists to participate in the fight against cancer without being unrealistic and over-confident about the treatment outcome.
Patients’ Explanatory Models of Acupuncture: How and Why do They Think it Works?
Sylvia Schroer EJOM Vol. 5 No. 1
This article reports on a small study to investigate how patients explained the workings of acupuncture in the light of their own experience of treatment. 15 patients of different ages and from socio-economic backgrounds were interviewed and issues such as reasons for having treatment, the effects of treatment, and the importance of the therapeutic relationship were discussed to reveal the explanatory models which they used to describe their experiences. One of the findings of the study was that patients’ narratives shifted during the course of treatment from mechanical theories or physical explanations of illness towards theories of equilibrium, of mind-body harmony, and ethical theories, with treatment seen as a cleansing process. The study found that also found that patients themselves, through their experience of treatment, are moving away from a narrow definition of acupuncture as a treatment for the relief of pain or physical symptoms towards a much broader conceptualisation for its therapeutic potential in the context of their lives.
The Experience of Receiving Traditional Chinese Acupuncture
G Walker, B de Valois, T Young, R Davies, and J Maher EJOM Vol. 4 No. 5
This article reports on a study by the Supportive Oncology Research Team at Lynda Jackson Macmillan Centre, Mount VernonHospital, Northwood, Middlesex, to evaluate the experience of women with breast cancer having treatment for the menopausal symptoms associated with Tamoxifen. A total of 16 women participated in focus groups held at least 9 months after their last acupuncture treatment. The discussions addressed the following topics: problems experienced before treatment; anticipation and expectation; experiences of the treatment session itself; effects of treatment; and overall impressions. It was found that traditional acupuncture is an acceptable treatment for women with menopause-like symptoms resulting from Tamoxifen. Patients found the overall experience enjoyable, and felt that their quality of life improved whether or not their symptoms were relieved.
Bearing Witness: Implications of the Law of Negligence for the Acupuncture Profession
Richard James EJOM Vol. 4 No. 5
This article reflects the author’s experience as an expert witness, illustrated with real scenarios.It identifies issues facing the profession and raises a number of questions:When does a professional relationship end? How should we interpret the Bolam test? Is our practice logically defensible in court? What is the boundary between counselling and being a good listener etc. The author emphasizes the importance of keeping immaculate case notes. Any legal defence is built on the foundation of solid case notes. If this foundation is shaky the defence will fall down. A valuable article for any practitioner worried about being sued.
The Space Shared Between Patient and Acupuncturist
Elisa Rossi EJOM Vol. 3 No. 2
This article sees itself as the starting point for a discussion about the aspects in its title. It starts out by examining what the classics (Ling Shu and Su Wen) had to say about the practitioner-patient relationship, their internal attitudes and the space in which they interact.It looks at the definition of a good acupuncturist, including the governing of Shen, the arrival of Qi and the observing of the patient’s reaction.It talks about the darker side of illness, when we are ignorant, or when the doctor is drawn into being ‘contaminated’ by the patient’s pain or suffering.It focuses on 'the concepts of transference and counter transference, the setting, therapeutic alliance, empathy and neutrality, contract and recovery', and the avoidance of errors arising from the deeper dynamics of the relationship, which may cause anti-therapeutic responses.
This article explores what practising ethically means with specific reference to the practitioner/patient relationship in complementary medicine. What emerges is that the practitioner’s responsibilities need to be looked at alongside the patient’s self-responsibility and active participation in the therapeutic exchange. Read the whole article
Tasking Our Patients
John Hicks EJOM Vol. 2 No. 2
In this article the author suggests that by understanding the patient’s model of the world (borrowing from the theoretical framework of neuro-linguistic programming), a practitioner may be able to produce tasks for the patient which will reduce the frequency and intensity of negative emotional episodes which may be the ‘cause’ of disease.
Ants and Acorns: Some Thoughts on Complexity, Chaos and the Therapeutic Relationship
Francesca Diebschlag EJOM Vol. 2 No. 2
Diebschlag outlines the main features of the sciences of complexity, those sciences which deal with self-organising systems such as general systems theory and chaos theory and how they might inform what occurs in the therapeutic encounter.
From his experience of working with people with chronic illness, Desser looks at how their stories of illness, sadness or pain have become their life and imprison them. Using case-studies as examples he explores working with TCM ideas and systemic ideas about communication and relationship to help effect change.
An approach to catastrophic illnesses, diseases which are more than life threatening, they are life overturning. Self-empowerment is as important as the relief of symptoms. Such illnesses can be a powerful catalyst for positive change.
