Survey of Patient Profiles Attending for Acupuncture
Mary Pender EJOM Vol. 8 No. 1 (2015) Acupuncture is now considered an evidence-based treatment for multiple conditions and is being incorporated into mainstream healthcare1. Many factors influence patients’ decisions to attend for acupuncture treatment.
The aim of this study is to review the demographics of patients who attended an established acupuncture clinic over a period of 20 years, to determine their diagnosis, referral source, and factors influencing their decision to attend for treatment.
A questionnaire was given to people when they attended for treatment. The majority answered the questions while at the office. Some people took them away and returned them at a later date. The design was simple, comprised three pages and took about five minutes to complete.
With the help of this questionnaire we looked at patients’ age groups, how many times they attended, who recommended them, what problems they suffered with and what their expectations were regarding the treatment and the treatment outcome.
Survey and Audit to Evaluate Our Work - Finding a Model which Describes the Way We Work
Friedrich Staebler EJOM Vol. 8 No. 1 (2015) Survey and audit are useful ways of monitoring our work, of taking a closer look at who has attended our clinic over what period of time, what kind of condition(s) they presented with and how they responded to treatment. This can be done in search of outcome and evidence (audit), or for evaluating our work and learning from the successes and failures, leading to better fine-tuning and ultimately more efficient ways of working (survey).
As I have seen a trend over recent years towards a majority of long-term patients with chronic conditions, not easily classifiable with a diagnosis and often with multifactorial underlying pathology, who required individually tailored, long-term treatments, I had to find a format for surveying the outcome of my work that would be adequate for that task. I studied various commonly employed methods to measure treatment outcome, like MYMOP and the SF-36 health survey, but ended up with a survey format which I developed for myself. This article is an attempt to describe that process.
Tai Lahans EJOM Vol. 7 No. 6 (2014) Except for lung and cervical cancers, all other cancers in the USA are rising in incidence. This rise has occurred within the last half of the 20th century. What happened and is happening to cause this? What is our role and what can we do?
In general, the public don’t perceive that acupuncture is a suitable form of medicine for babies and young children. In truth, acupuncture and other related techniques, such as shonishin and paediatric tui na, are well tolerated by children and immensely effective at treating many of the conditions from which they suffer. The Panda Clinic was set up in the hope that, by raising awareness, more children would receive the benefits of treatment. Children come to the Panda Clinic with a wide range of chronic and acute conditions. As well as providing effective treatment, it aims to be an environment where children feel welcomed, listened to and safe. This article aims to give the reader a flavour of life at the Panda Clinic, including some of the patient management issues that are peculiar to the treatment of children.
The Therapeutic role of the Practitioners Heart in Classical Chinese Medicine and Modern Medical
Stephane Espinosa EJOM Vol. 7 No. 5 (2014)
This critical literature review focuses on the therapeutic role of the practitioner’s heart, with emphasis on the acupuncturist’s perspective. The relevant descriptions given in classical Chinese medicine are presented. In particular, the appropriate attitude of the practitioner during treatment is discussed, highlighting the importance of compassion and clarity of intention. This is followed by a description of the acupuncture needle’s role of energetic link with the patient. Parallels were identified with results from modern research showing that positive emotions such as compassion increase the coherence of the cardiac electromagnetic field, and thereby interpersonal effects such as cardiac energy exchange and synchronisation of heart rates and heart-brain wave patterns. The importance of these findings in providing a rationale for a patient-centred approach to treatment is discussed, together with the need for further research within the framework of modern validation of classical Chinese medicine.
"Defining best practice...? Elementary my dear researcher."
Andrew Flower EJOM Vol. 6 No. 4
In this brief but engaging article, the author ruminates on the political nature of research and on the problems this poses for East Asian Medicine, and points to the fact that the thorny business of defining best (or at least 'good enough') practice is of central importance here. He concludes by offering a richly simple model - based on the Five Phases (wu xing) - for defining what best practice is.
An increasing number of women undergoing in vitro fertilisation (IVF) are seeking to use acupuncture as a result of its growing reputation for increasing the chances of conception when used as an adjunctive therapy. Those of us involved in this work may feel a sense of joy and satisfaction at being able to assist someone through such a fundamentally life changing experience. At the same time, many practitioners express discomfort with the nature of the medicine involved and feel their role is mostly limited to one of supporting the patient’s health through a physically and emotionally sapping drug regime. Acupuncturists can feel torn between the desire to help the person become pregnant and the desire to distance themselves from a medical practice they see as harmful. This article aims to examine and expose some of the ways in which our humanity is undermined by over reliance on IVF technology to correct infertility. It is hoped that by confronting the difficult ethical problems created by IVF medicine, our profession may recognise its unique capacity to provide a comprehensive fertility treatment for women and will seek to do this at a greater distance from today’s IVF clinics.
Epistemological Orientations to Acupuncture Practice
Barry Nester EJOM Vol. 6 No. 1 (2008)
This paper explores some ‘epistemological orientations to practice’ that can be drawn upon by academics and practitioners involved in Chinese medicine to understand acupuncture knowledge and professional practice. Using the theoretical framework of Anne Mosey (1992) that she used to examine the health professions, it is argued that the four epistemological orientations to practice identified by Mosey can be reflected upon to better understand acupuncture practice and the acupuncture profession. This analysis helps to understand the reasons for some of the developments of the acupuncture profession, and helps to clarify the underlying assumptions and premises for the diverse opinions on the best way forward for the development of acupuncture knowledge, practice and research.
The Path from Doer to Witness: Reflections on an Acupuncture Practice
Marian Fixler EJOM Vol. 5 No. 6
The author, a busy practitioner with a 5 year old child, reflects on almost 2 decades' experience as an acupuncturist. She points to the importance of being able to put aside all the pressures and demands in one's life and connect with patients in the treatment room. Striving for this 'sense of connectedness', through supportive networks, treatment exchange, study groups etc., has helped her practice develop and thrive.
The author, who qualified from the College of Traditional Acupuncture in the mid 1980s, gives a brief account of her personal journey into acupuncture. She then explores the significance of acupuncture as a career and as a calling or vocation and expresses her concern that, as acupuncture becomes increasingly more mainstream, the former may tend to eclipse the latter. Read the whole article
The Road to Valencia
EJOM Vol. 5 No. 6
The author describes her path from Moscow where she studied journalism, to London where she studied acupuncture and shiatsu, and on to Valencia, Spain, where she now runs a busy practice. She points out some of the cultural differences facing an acupuncturist in Spain compared to the UK, and lists factors that have contributed to her success in setting up practice there.
Reflective Practice, Professionalism and Acupuncture Education
Ann Hopper and Allen Parrott EJOM Vol. 5 No. 1
Although reflective practice has been adopted as an educational approach in a number of mainstream professions over the years, it would seem to have a special affinity with the emerging profession of traditional acupuncture. Like acupuncture, reflective practice encourages people to look at everyday experience in a different way. Both insist on the uniqueness of particular situations and the importance of context. Each shares a suspicion of ‘off-the-peg’ prescriptions and universal solutions to life’s problems. In these ways they act as a necessary counterweight to the current dominance in the western world of a narrow scientific and objectivist approach to life and knowledge. The authors carefully deconstruct the view that reflective practice means nothing more than a mental review or a rehearsal in the brain of things that have happened during one’s working day, and then move on to discuss the teaching and learning of reflective practice on professional degree courses. Read the whole article
Language Referencing in the Teaching of Chinese Medicine
Frances Turner EJOM Vol. 4 No. 5
This article - subtitled 'How Teachers’ Use of Language Reflects Their Perception of the Characteristics of Chinese Medicine' - is a summary of an MPhil research degree, completed by the author at ExeterUniversity in 2003.The study, which was based on interviews with 20 practitioners, teachers and authors of Chinese medicine, examined respondent approaches to the importance of language in the teaching of Chinese medicine, ranging from the view that it is practice which is important, not language, to the view that theory and practice, like language and understanding, are inextricably linked in a circular relationship, and that language is central to the preservation of Chinese medicine itself.The non-standardisation of the language of Chinese medicine in the West reflects a rich melting pot of different approaches to the discipline itself. The author considers that one of the most interesting findings of this study was that since our understanding of what we do is expressed in the language we use, our language use is a reflection of what we perceive Chinese medicine to be. Read the whole article.
Nei Guan: The Inner Gaze - Reflective Practice in Acupuncture Traditions
Richard Blackwell and Paul Hougham EJOM Vol. 3 No. 5
The authors review aspects of what has been termed ‘reflective practice’ and go on to identify its themes within acupuncture traditions. They cite hua (transformation) as our point of origin for education, medicine and spiritual practice; they examine the nature of engaged awareness and the path of the heart; they explore the concept of reflection itself and its role at the core of Daoist alchemy; they develop the notion of acupuncture traditions forming a body of knowledge rather than mere intellectual knowing, and explore the challenges inherent in working from somatic knowledge. They conclude by revisiting reflective practice in the light of Scheid and Bensky’s work on yi - signification, or intent - (published in EJOM Vol. 2 No. 6; Winter 1998/99), and argue for a wide interpretation of reflective practice within acupuncture traditions that honours their roots and diversity and embraces bodywork and the cultivation of inner stillness as much as it does intellectual knowledge. Read the whole article
Western Psychotherapy: An Introductory Overview - Whither the Yin and the Yang?
Kevin Baker EJOM Vol. 2 No. 5
Baker describes the development of modern Western psychotherapy, and Core Process Psychotherapy (CPP), which integrates eastern spiritual traditions with psychotherapy. From this psycho-spiritual perspective, patterns within one's life situations, as well as deeper existential issues including impermanence, insubstantiality and the truth of suffering are explored. The qualities of the therapist are also discussed.
This paper seeks to explain the inner deliberations of a clinical teacher in an acupuncture clinic. The intentions of the research were twofold: to explore the method of reflection as a research tool within clinical teaching and through this to illuminate the personal filters through which I view my teaching. Reflection is a powerful tool that can help reveal the dissonance between our espoused theories of adult education and our theories-in-use. Being both patient-centred and student-centred generates tensions that impact on our teaching.
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.
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.
Polluted Bodies, Individual Responsibility and Personal Blame
Sylvia Schroer EJOM Vol. 4 No. 5
This article, derived from a larger project initiated by the author and Dr. Vivienne Lo of UCL’s Wellcome Trust Centre for the History of Medicine, focuses on contemporary practice in the European context in relation to the Chinese medical concept of xie (often translated as ‘evil’ but also implying the opposite of zheng or ‘upright’). The author suggests that modern TCM texts have played down or completed excluded the concept of xie,arguably through systematic attempts to scientise medicine and eliminate superstitious and feudal elements. In the study, 15 acupuncturists were interviewed, all but one of whom had some training in Worsley and/or Toyohari styles of practice – approaches which the researchers considered to be more relevant to the theme of xie. Two techniques taught by Worsley were found to be related to the xie concept:one taught as ‘internal/external devils’ and related to various states of emotional distress including ‘madness’ and depression; the otheremerged in a treatment known as ‘aggressive energy’, something external to be drained away. The author explores the practitioners’ approaches to xie and how they talk about it with patients. The study reveals how practitioners have adapted the moral concerns inherent in the concept of xie to the ecological debate that has increasingly taken centre stage since the 60s and 70s.
Ancient Chinese medical texts do not in themselves form a complete, workable system of psychology. They restrict themselves to a discussion of certain aspects of psychology in the context of diagnosis and treatment of the qi. The author suggests that a broader picture of the ancient Chinese understanding of human psychology can be derived from a study of ancient Chinese literature, particularly the philosophical classics. He discusses a number of mainly Confucian concepts in order to sketch in some of the ‘background’ ideas about the psychological nature of man.
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.
Continuing Professional Development: A Pilot Study
Emma White EJOM Vol. 3 No. 6
This paper presents the findings from a survey conducted on behalf of the British Acupuncture Council (BAcC). It was conducted among 121 members in June 2001. The aim of the survey was to assist the BAcC to prepare a Continuing Professional Development (CPD) programme for members which takes account of the CPD members are already doing as part of their busy practices, and which also takes into account the acupuncture tradition. This paper sets out the survey design and then goes on to report on three aspects of the survey.
Making Use of Acupuncture - A Psychotherapist's View
Pauline Lucas EJOM Vol. 2 No. 5
This short article by an acupuncture client, who is a psychotherapist, describes her experience of using acupuncture. She found that TCM explanations complemented her own body-mind understanding and compared how psychotherapy opened up suppressed feelings while acupuncture similarly opened up blocked energy channels. This was effective both for the patient's physical and emotional well-being.
Preparing Professional Practitioners: Two Approaches
Della Fish EJOM Vol. 1 No. 6
Della Fish, the accreditation officer for the British Acupuncture Accreditation Board and former principal lecturer in education at Brunel University, shares some personal thoughts about the complexities of designing educational programmes both to prepare students to become professional practitioners and to further develop their expertise. She discusses competency-based professional education and reflective practitioner philosophy.
Felicity Moir, principal of the London School of Acupuncture and Traditional Chinese Medicine, discusses ways in which her college has worked towards developing their students as reflective practitioners, with the introduction of problem-based learning, changes in learning methods and a re-education of teachers, so that they can assist these techniques.
Orientalism Revisited: Reflections on Scholarship, Research and Professionalism
Volker Scheid EJOM Vol. 1 No. 2
The author explains why he believes that research in Chinese medicine, in the narrow sense of 'research' as it is defined in the orthodox medical establishment, is a process which is likely to lead to Chinese medicine's being subsumed within the orthodox medical framework. He analyses what may happen when one cultural tradition encounters another, and proposes as his ideal for the Western and Chinese medical traditions an encounter where both traditions meet to forge something completely new and different. To facilitate this process, he proposes a model of research more akin to the broader and more deeply questioning research in the social sciences than to the narrower hypothesis testing of the medical establishment.
An Exploration of Ken Wilber’s ‘Integral Vision’ and How it Might Relate to Acupuncturists
Gregor Joepgen EJOM Vol. 4 No. 3
This article explores the work of the American author Ken Wilber, especially looking at those aspects of his theory that might be important for those acupuncturists who are seeking to work as 'integral informed practitioners'. It was decided to use Wilber's term 'integral informed' rather than 'holistic practitioner', because it was felt that the word holistic has been used too often and in a fashion which encompasses all sorts of ideas making it often confusing and not descriptive enough any more. An integral informed practitioner, as Wilber puts it, is someone who is healed and 'wholed' first themselves, before helping others. As will be discussed by the author in more detail, Wilber describes development as a process of transcending and including. Here growth of consciousness therefore means transcending and including, and one might also call it transformation. If we become able through understanding to transcend our own limited views and then to include these views in a new and more spacious awareness and outlook on the world, then our experience will be one which is truly free, to both meet and engage with the new.
The Role of Standardised Textbooks and Learning Acumoxa in Contemporary China
Cinzia Scorzon EJOM Vol. 4 No. 2
This article is an extract from the author's MSc dissertation. It examines the function of standardised Chinese medicine (CM) textbooks in contemporary China. In her thesis, she investigates how standardised textbooks of acupuncture and moxibustion1 were initially written, introduced and used in the TCM universities in contemporary China. The first edition of these textbooks was compiled at the end of the 1950s; since then they have been used as course material in CM universities nationwide in the teaching of undergraduate courses on which written examinations are based. The textbooks are regularly revised and updated and the most recent sixth edition was introduced in the late 1990s. What is the role, however, that these contemporary textbooks play in learning CM?