Chinese medicine training – naturally outstanding
Follow the experiences of acupuncture students and graduates at LCTA and find out what it's really like to study Traditional Chinese MedicineLCTA ESTABLISHES COLLABORATION WITH LEADING TCM COLLEGE IN ARIZONA
LCTA recently signed an agreement with the Phoenix Institute of Herbal Medicine & Acupuncture (PIHMA). Strategic Development Director, Susanna Dowie, explains:
“One of the projects I have been working on since I changed roles, is the development of relationships with TCM colleges abroad. The world is getting smaller and TCM is a common language, crossing language and geographical boundaries. Many of our students either come to study here from abroad, or express a desire to practice in other countries once they qualify, but often they need additional qualifications to be able to set up practice. Our aim is therefore to facilitate the transfer of expertise internationally through collaborations with foreign colleges.
“We visited PIHMA in July and I was astounded by how similar it is to LCTA. It is a bright, interesting and modern college that was set up 14 years ago (not long after LCTA) by President and Founder, Catherine Niemiec. PIHMA shares our views and teaching ethos and it was fascinating to travel so far and discover a college with a set-up so close to our own and in such vibrant surroundings.
“Earlier this term, Catherine visited us and we agreed on an open exchange of policies, procedures and curriculum. We are working together to develop an exchange programme for students and ultimately aim to create a mechanism to enable our graduates to obtain the necessary State qualification to practice over there and for PIHMA graduates to do likewise in the UK. We are also looking at the possibility of a collaborative TCM research initiative.”
“We are very excited to be working with an institution that is so in tune with us and we look forward to developing a close relationship with Catherine and her team.”
Information on PIHMA can be found at www.pihma.edu
Acupuncture training is hard work but worth it. I just love it!
Charlie originally studied photography but left university when she was pregnant with her first child.
She suffered with anorexia and after a variety of treatments including anti-depressants, hospitalisation and cognitive behavioural therapy she decided to try acupuncture.
Her acupuncturist succeeded in helping her to overcome the anorexia and she is now in her first year of the BSc in Acupuncture at LCTA. Here she tells us about her experiences:
I thought about studying acupuncture a lot when I was being treated. To me, acupuncture was something really special as it had succeeded in helping me where nothing else had. I had done so many other therapies that hadn’t worked and know that conventional medicine didn’t hold the answer for me. I believed in it so strongly because of my own experiences of both Anorexia and Depression and I just really wanted to show other people how good it is.
I also really wanted to be able to help other people to get better. I had such a caring acupuncturist and I wanted to be like him – he was so helpful and so fantastic, I looked forward to seeing him each week because he made me feel so much better. When I qualify, I think I would like to look at treating Anorexia but I’m also interested in infertility and I would love to learn how to treat children.
I started at LCTA in September 2009. I went to look at a couple of colleges but preferred LCTA when I found it online because the other colleges I looked at only covered the Five Elements. I really liked the fact that LCTA doesn’t just focus on this one aspect – it covers all Chinese medicine theory so you get a really good grounding.
I also liked the fact that if I wanted to, I could study Chinese herbal medicine at a later point. When I walked into the College for a Presentation Day, I knew it was the right place for me. There was a really nice feeling about it. Everyone knows each other, it doesn’t feel too big and everyone’s really nice. I started a week after the Presentation Day and I love it. I did my first clinic observation just before Christmas and the more I do, the more I know that it is the right thing.
Since having my second son, I haven’t relapsed, although I have struggled at times. My mum is really pleased that I have got to where I am now and she has lent me the fees so that I can do the course.
The course is hard work but enjoyable. I am on the weekend, part-time course which will take four years. I travel down from Milton Keynes on the weekends for class and work at Starbucks locally during the week. My mum has my two sons on a Saturday and my husband looks after them on Sundays, he is a Pharmacist and has Sunday and Monday off so we usually get some time together after my early shift on a Monday afternoon.
College is great. It’s very different from school where everyone was competitive. All of us share information which is really good. We all read different books and often photocopy interesting pages for the rest of the class. There’s a real mix of backgrounds in my group and we all get on really well, everyone is really supportive, which is fantastic. Even the second years offer to help us and it’s nice to know we have their support too. We also know everyone in the office and all the tutors who are also really helpful and much more approachable than the ones I had at university – they give us their email addresses and genuinely don’t mind if we contact them. We all work at the same level and there’s a really nice atmosphere, I just love it.
The work is interesting and hard. Chinese Medicine Theory (CMT) is my favourite subject. Some people find it hard to leave conventional medicine behind (they can’t accept that the ‘Liver’ is not where it is in Western terms) but I find it easy to accept it as it is.
You start to look at people and relate what you have learnt in CMT to what you are seeing. My eldest has nose bleeds during the night and night sweats. I recently learnt that Kidney Yin deficiency can cause night sweats. I don’t know how to treat it yet so it makes me want to learn more so that eventually I will be able to.
We are constantly learning and we all take it away with us and apply it, I look at people and think ‘ooh they are Damp’ and I always go home and tell everyone the new facts that I’ve picked up. One lesson we learnt that bananas aren’t good for some people as they cause Damp in the body and take a long time to be processed. For about two weeks afterwards it was a bit of a joke if anyone ate a banana!
Having a chance to observe treatments in the Teaching Clinic and listen to the discussions is really fascinating. We have to do five days of clinic in the first year and I managed to see some really interesting cases on my first observation day. We have done some tongue diagnosis, so I can understand a little of what the practitioners and third years are discussing. We’ve also done some work on pulses and they let us look at the patients’ tongues and check their pulses. I was quite pleased because I managed to pick up the same things as the practitioners. I didn’t necessarily know what it all meant but I knew what to look out for. Having the Teaching Clinic is a really big advantage as not all colleges have one. My next clinic day is in February and I’ll know more than last time so it will be fun.
The course is hard work but worth it. I tend to study when the kids are in bed – I leave my husband watching television and I take all my books and work in bed. I also read a lot of Chinese medicine theory books; whilst everyone I work with is raving about the Twilight Saga, I am reading about the Yellow Emperor!
Acupuncture training is likely to change not just their careers, but also their lives
Linda has been at LCTA for a year as the Undergraduate Course Administrator looking after all of the acupuncture students. Here she explains a bit about what she does:
My role at LCTA is to answer any queries and deal with any problems that the acupuncture students may have. Once the course begins, from day one, I’m the person they speak to about overdue course work, exam results and anything else that might be affecting them on a day-to-day basis.
The students first meet me at their Introduction Day. Bonny and I go through information about the College and give them the relevant documentation and hand outs. We also set up team exercises so that they can get to know each other. It’s especially nice to meet the students right at the outset. When I started a year ago, everyone had already begun the course and so it took me a bit longer to establish relationships with them.
The Introduction Day is a really good day. I had my first one with the March intake. I was absolutely petrified but as soon as it got going it was great. I’m sure the students were nervous too, after all they were in a group of people they didn’t know at the start of a long course that would change not just their careers but also their lives – it must be scary.
I deal with all students in all years and no two groups are the same. The dynamics of each group are very different and weekend students are different to weekday ones. There aren’t any specific stages that every set of students goes through or specific issues that arise, you just take each group as it comes.
Exam time is the busiest time of year for me. Everything else stops so that we can focus on that and then we have to get everything in order again before the beginning of another new year. The main thing we notice with the students awaiting their final exam results is a general eagerness. They want their results because they want to get on with setting up their practice.
When they come back for Graduation, the March ones especially haven’t seen each other for a while and so it’s a nice excuse to get together. We had a whale of a time at this year’s Graduation Ceremony. It was nice to mingle with the students for the last time before they took off to begin their new careers.
One of the graduates emailed me recently about something and she said it felt strange to think that they don’t have to come to College anymore. She said it felt like the end of an era, she was missing it a bit.
My main advice for new students is to enjoy the course and take each step as it comes. They may have some difficult times but they shouldn’t worry. They should always try to remember why you they are doing it and most importantly, just enjoy it.
The Statutory Regulation of Chinese Medicine: What you can do to help ensure it happens
Advice from LCTA Principal, Bonny Williams.
Statutory Regulation is essential for herbal medicine in this country. Having been committed to it so far, the government now looks like it has lost momentum.
Do not imagine that because the latest round of consultation on Statutory Regulation for Chinese medicine has passed, there is nothing more you can contribute. Even if you have already responded, whether you are a patient, a practitioner or an interested bystander, please write to your MP again urging the Government to go ahead with Statutory Regulation without any further delay. Each time you write a letter, your MP will let the Minister know that another letter has been received on this matter and the Minister will write back. This adds to the 5000 or so letters she has already received in this consultation round. Every single one helps our case.
So what do you say? Here is a rundown of the current situation:
Why statutory regulation is in the public interest:
- Government has committed to statutory regulation of herbal medicine and acupuncture practitioners since 2001. In 1995 it published the result of a public consultation showing a 98% positive public response in favour of statutory regulation of this sector, but since then they have lost momentum. Now another public consultation has just finished. If statutory regulation is not granted very soon, the impact of new EU legislation on herbal practice and supply in 2011 will be devastating.
- Herbal medicine is very popular and its use in the UK is widespread. According to an Ipsos MORI poll (November 2008) conducted for the Medicines and Healthcare products Regulatory Agency (MHRA), 26% of UK adults have used a herbal medicine in the last two years and of those using herbal medicines, 56% had used a herbal medicine supplied by a practitioner.
- The only way to be assured of well-qualified practitioners is via statutory regulation. Neither voluntary regulation nor licensing ensure independent regulation and accreditation of training programmes or continuous professional development. Only statutory regulation can ensure the continued availability of a wide range of herbal products.
- Statutory regulation will make practitioners ‘authorised health professionals’ under the terms of the main EU Medicines Directive (2001/83/EC) and will allow them to have herbal medicines made by third-party manufacturers and suppliers under licence from the MHRA. This will ensure good quality products and continued supply of a wide range of herbal medicines
- If herbalists are statutorily regulated like osteopaths and chiropractors, doctors will be able to safely refer patients for treatment
What will happen if statutory regulation does not go ahead:
- If statutory regulation does not happen, the 2011 EU directive specifies that herbal medicines made for specific patients by a third party supplier should be removed from the market (e.g. traditional Chinese herbal medicine products). Without statutory regulation, only herbal mixtures made on the practitioners’ own premises will be allowed to be supplied to patients. This will mean a great loss of consumer choice. Also a considerable number of suppliers and practitioners will go out of business.
- As a result consumers will be forced to buy from unsafe internet sites or from bogus back-street practitioners.
- Herbal medicine training is now to degree level – a postgraduate MSc degree at LCTA. Without statutory regulation universities will be reluctant to support herbal training – undoing years of work to ensure high standards of training.
If you think herbal medicine should be allowed to survive in this country, please write to your MP today in support of herbal Statutory Regulation. It will make a real difference.
What happens when you first contact us?
Natasha has been at LCTA for nearly four years. She has been working part-time on reception since early October but previously dealt with enrolments. Here she explains what happens when a prospective student first contacts LCTA.
For the past four years I have been the first point of contact for all the enquiry calls and emails that come in from prospective students. I also worked with the receptionists who assisted me with parts of the application process.
A large part of the job was about getting to know people, helping them to decide on their studies and supporting them through the application and enrolment process. There’s a lot of paperwork involved – keeping track of attendance for Presentation Days, contacting references, arranging interviews and making sure all student paperwork is up-to-date. I was also responsible for helping students who enrolled straight into the second or final year of the acupuncture course – either because they had other qualifications that gave them exemptions, or because they were transferring from other colleges – they need to be eased in and introduced to their year group.
One of my main responsibilities was running the regular Presentation Days that we hold at the College for prospective students. Presentation Days are free and they are a great opportunity for people to experience a taste of the College. We give them a really good understanding of the course and our teaching style and quite often the decision to study here is made at one of these Days. The Presentation Day is a really lovely day and it’s so nice to meet prospective students, it makes the conversations over the phone afterwards when we are sorting out actual enrolment, a great deal easier.
This year’s Graduation Ceremony was fantastic – although it seems like a long time ago now. Everyone really enjoyed it and it was really special for me as a lot of the graduates were the first people I enrolled for LCTA when I started – back when we were in the old building on Ballard’s Lane. It was really lovely to see their journey through studying and then finally to graduating. They all have so many different backgrounds but they come together with a common goal. We see how hard they work and for them to finally achieve their goal is fantastic and makes everyone feel really good.
Apart from Graduation, September was my busiest month of the year, I was enrolling constantly and the phones didn’t stop. I had to speak to all the new students and ensure they had everything they needed, chase up fees and sort out students who decided to enrol last minute. Once the students actually start studying, they are handed over to Linda and I get on with the next lot.
March enrolment is well underway now with Eleanor working in my old role. I no longer look after prospective students but because I’m on reception, I get to see those that I have enrolled a lot more, which is great and I’m really enjoying it.
I’M A 67 YEAR OLD STUDENT STARTING OVER AGAIN
It’s like swimming in beautiful coral without being able to see below the surface and then putting on a snorkelling mask and suddenly realising what you have been missing!
At 67, Tony embarked on his first year at LCTA studying acupuncture. Originally from the US, Tony spent most of his working life with the American overseas school system, teaching English and social studies. Tony lived and worked as a teacher and school administrator in the Orient for 15 years, travelling extensively and teaching in the Philippines, Taiwan and Korea.
When he retired in 2004, he was also assistant headmaster at one of the European schools.
I have been fervently interested in the Orient for many years and have studied qi gong, tai chi and other martial arts. I have also studied Chinese literature but because of my work and responsibilities, I have been unable to pursue my interest in any real depth until now.
Studying Traditional Chinese Medicine (TCM) has finally given me the opportunity to tie all my previous studies together. In fact, even in this first year of study, I discovered how TCM simply embellishes and enhances other areas of oriental theory and history, giving me a better insight into my previous studies.
When I retired, I realised that it was not in my nature to do nothing and so I began to research massage courses in the US. I was actually about to enrol on a course when I came across LCTA in an internet search. My wife told me to go to the College and find out more. She told me that since I had always been interested in Oriental medicine and massage, I should see what was on offer. When I went to a Presentation Day at the College, I immediately knew that that was where I wanted to be.
So now I am studying something that I had no background in or previous knowledge of and I am just a struggling freshman. Learning acupuncture, anatomy and point location has been an exciting and wonderful experience. I have never had to look at things in 3D, or reverse images in my head. Most of my experience has been in the written word, rather than in practical applications and images. It hasn’t been easy, in fact parts of the course have been very difficult, but I wouldn’t have it any other way and I would certainly choose this course again if I started over.
The whole experience is about personal completion for me. Age is no barrier, my motivation is higher because I feel like there is not much time left and I feel good because at least I’m trying. I feel like I am rounding off everything that I have done over the years – all the qi gong, tai chi and studying I did has come together because it’s all embodied in the Chinese classics and Chinese medicine plays such a great part in them. I’d looked at the practical aspects of Daoism but had not explored Chinese medicine – I’d only really skimmed the surface in my reading. I have bought many different Chinese medicine texts over the years but have never really understood them. Now I have this wonderful opportunity to really learn and understand them in depth.
Studying Chinese medicine is a fulfilling and life-changing experience. I understand myself better and see things from a different perspective. TCM makes you view things on a different level; it gives you more of a rounded, 3D vision of life. It has brought into reality things that were previously just theory to me.
The first year was absolutely fantastic, I couldn’t have asked for a better year despite the pressures of the work and the traveling. My studies will enable me to use qi gong and tai chi in a more definitive way and I would like to specialise in treating older people. If I never practise, I will still feel a huge sense of personal fulfillment and accomplishment. I really couldn’t have asked for a more revealing and more brilliant experience.
I have had only encouragement from my family, friends and colleagues and couldn’t have done this without my wife’s support. Everyone at LCTA takes the studying very seriously and the teachers and curriculum are excellent. My classmates are a tremendous group of people, age is no barrier and everything we accomplish, we do so together. I didn’t expect to find such a great group of people when I began the course. Everyone is there to learn and to help each other; it gives a whole new focus to life and friendship.
When I retired from my job as a teacher, I left happy. I just realised one day that I didn’t want to do it any more. TCM has taught me that you have to know when it’s time to leave; you shouldn’t leave with an arthritic soul. The irony is that had I stayed doing what I no longer wanted to do, I would have become ill.
The opportunity to study TCM is proving to be an unforgettable experience. I feel incredibly lucky; not only am I surrounded by great teachers and classmates, but I have also been fortunate to have been taught qi gong and martial arts by masters who have had an enormous effect on me over the years.
Everybody finds their own path in life and although in some ways I wish I had done this earlier, I’m not sure I was ready for a transition like this. I often tell my classmates that I envy their youth but what I really envy is the fact that they have 30 or 40 more years to study Chinese medicine. When you enter the College, you enter another world in which everybody is intensely involved and concepts like Qi become realities. TCM is a way of life rather than something you dip in and out of, it is an entity that becomes part of you and that’s what the school has become to me. It’s another world with a high seriousness about it that I really love.
Learning through experience at the Teaching Clinic
Anna Bernard recently joined LCTA as Teaching Clinic Practice Manager. Here she tells us a bit about herself and explains how the clinic works.
Anna tells us what happens in the LCTA Teaching Clinic
I’ve been a qualified acupuncturist for seven years. I ran the Neal’s Yard therapy rooms five years ago and then left to focus on my own practice. I worked with Zita West for a year and set up a vocal clinic specialising in singing and presenting for voiceovers which is the other thing that I do to earn a living. Coming back into such a creative college environment is great; the student environment is fantastic, it’s the best environment to learn in.
In my role as Teaching Clinic Practice Manager I co-ordinate all of the student clinics across acupuncture, herbs and tui na. I look after both the day-to-day and the strategic management of the clinic, looking at the patient experience and working out how we can give our students the best possible teaching. This includes ensuring that we attract enough patients for our students to learn from, so I am looking at ways of branching out into the community.
The ideal patient is probably a difficult one: whether it’s a difficult case or just a difficult personality; for instance, a patient who turns up late, or one who doesn’t turn up at all, although it is nice to have a patient who they treat weekly for 12 weeks and see them get better – as this gives the students confidence. But whilst they are a student it’s also good to have a difficult case so that they can experience as much as possible before they graduate and set up on their own.
The final year students have four clinic blocks lasting eight weeks each and the number of patients is built up slowly but surely so that in the first block they will treat one to two patients per week and by the fourth block, they will have a fairly solid clinic day. We make sure that they have enough patients to be continually learning.
Part of the clinic day is a two-hour discussion as a group with the clinic supervisor. There is a set amount that has to be taught in the clinic for each block and the discussion time is also used to discuss stuff that comes up with patients. So if a student has an interesting case, they have the opportunity to discuss how best to deal with it and all the students have a chance to learn from it through discussion.
The Teaching Clinic gives the students a really valuable insight into what it is like to run a practice. They get to experience the good and the bad days, the easy and the difficult patients and they learn how to deal with their personal issues – it’s a real journey.
This group of third years is incredible, they have been so good and all the supervisors are really pleased with their progress in this first clinic block. They work fast and are focused, they’re a very strong group. This is really exciting for me and you can really feel it in the clinic as well – people are coming back and booking in all the time. Part of the requirement of the clinical year is that students see and retain a certain number of patients, so this cohort have got off to a great start.
There are clinics available every day apart from Wednesdays and if you don’t mind being observed, it’s a fantastic way to get treated.
For more information about the LCTA Teaching Clinic see the news and information section of the blog.
Being a mother and an acupuncture student
Many women find that their priorities change when they become mothers. A job that may have been fulfilling and exciting when you were young, free and single, sometimes becomes less appealing or more difficult to manage with a family to care for. Of course, there are a huge variety of careers that you can choose to train for, but it’s often difficult to fit studying around your children.
Louise recently graduated in acupuncture at LCTA. She explains what it was like to juggle her studies with being a mother:
Louise studied acupuncture part-time
I was a beauty therapist for several years before I moved to a pharmaceutical company, where I spent six years as a sales team co-ordinator. I missed the holistic environment that I had enjoyed as a therapist and so I began to look for something new that I could learn that would also provide me with opportunities to continue to develop. I had had some acupuncture treatment myself and had looked into studying TCM a year or so before I started at LCTA, but I had not found a course I could manage alongside my full-time job.
When I first came across LCTA I was very excited to find a part-time course. When I came for the Presentation Day I got a feeling that I was going to like Chinese medicine and now I know 100% that I made the right decision. Even after looking after my little boy all day, I would often go upstairs and concentrate on my studies – Chinese medicine definitely keeps you interested!
I found out I was pregnant about three weeks before I started the course. I’d been trying for a long time and had used acupuncture to conceive. I was so motivated to study Chinese medicine that I decided it would be fine to do the course and have a baby and just got on with it. Stanley was born about four weeks before the first year exams and I was back at College two and half weeks later. I took my point location book to hospital with me because I knew I had my exams coming up.
Studying Chinese medicine alongside being a mum really worked for me. I’m not someone who can sit and study for hours at a time – I have to do things visually, so I constantly looked for baby channels and acupuncture points on Stanley.
It was nice to have something to do with my brain and even nicer to know that before he turned two, I would be qualified and have a career that will fit in with my family life; that was one of the reasons why I did it – it was about work-life balance, not money.
I would like to work with other practitioners to begin with and perhaps later when I have more experience, I would like to practise from home. Fertility is a field I have particular interest in and I believe that I will have the advantage as a practitioner of being able to relate to my patients from my own personal experience. I would like to continue to add to my skills and I am considering studying Chinese herbal medicine as it can be used extremely effectively alongside acupuncture.
My advice to students is to not get stressed with the amount you have to learn during the first year. It seems like you are never going to manage and then in the second year, it all clicks into place. When you look at it, the Chinese way of doing things is actually very simple.
A guide to responding to the FINAL Government consultation on the Statutory Regulation of acupuncture and herbal medicine
Dear All,
One more time we are asking you to think about Statutory Regulation, so please do stay switched on for a couple more minutes.
This is the FINAL consultation for Statutory Regulation for acupuncture and herbal medicine: IT’S REALLY IMPORTANT YOU RESPOND
TO MAKE IT EASY: below is my suggested response. You can be as brief or as detailed as you like but do make sure you make one or two significant changes to wording because exact copies will not be counted as separate responses. Copy my response in essence if you like or think it through for yourself
DUE DATE: 16th November 09 (it’s been extended from 2nd).
HOW TO RESPOND:
By email : http://www.info.doh.gov.uk/questionnaire/ahmtcm_consultion.nsf
By post : Department of Health, Room 2N09, Quarry House, LEEDS LS2 7UE, email: consultations.co-ordinator@dh.gsi.gov.uk
You can also write to your MP, even after the consultation has closed. You can find your MP and his or her email address here: http://www.parliament.uk/mpslordsandoffices/mps_and_lords/alcm.cfm#N
FURTHER INFO: from BAcC, EHTPA, RCHM on line. My response is taken from these and my own research and understanding.
There are two relevant official documents you might want to read. Both have been written for experts so patients might find them hard going.
The Department of Health Steering Group Report concluded: “. . . there is an urgent need to proceed without delay to statutory regulation of practitioners of acupuncture, herbal medicine, traditional Chinese medicine and other traditional medicine systems.” The full report is available on the Department of Health website at: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_086359
The consultation document considers a range of alternatives to statutory regulation. It can be found here: http://www.dh.gov.uk/en/Consultations/Liveconsultations/DH_103567
WHO SHOULD RESPOND: if you have patients who would be prepared to contribute, please encourage them to complete the questionnaire also. They also can use my answers set out below, if it’s helpful.
The (very brief) history is:
House of Lords Select Committee report in 2000 and Department of Health reports in 02 and 06 recommended the regulation of Chinese medicine.
In the light of Shipman, etc. regulation was deferred while the entire structure of statutory healthcare regulation was reviewed.
In 2009 the Extending Professional Regulation Working Group (EPRWG) considered the need to regulate emerging healthcare professions including acupuncture and herbal medicine. Official BAcC response will happen in November 09.
Please spend a few minutes sending in your response. Statutory regulation is what will protect the public from ill-trained or disreputable practitioners, and what will safeguard our profession from those who disrespect what we do. THIS IS YOUR CHANCE TO DO YOUR BIT, AND WILL PROBABLY BE THE LAST OPPORTUNITY FOR YOU TO HAVE YOUR SAY. GO FOR IT – scroll down to see my answers to the consultation questionnaire.
With all good wishes,
Susanna
Susanna Dowie
The Statutory Regulation of Acupuncture, Herbal Medicine, Traditional Chinese Medicine and Other Traditional Medicine Systems
LCTA suggested response:
Please make one or two changes to each answer to ensure that your response is counted
October 2009
Question 1
What evidence is there of harm to the public currently as a result of the activities of acupuncturists, herbalists and traditional Chinese medical practitioners? What is its likelihood and severity?
Question 2
Would this harm be lessened by statutory regulation? If so, how?
Answer to Q1:
There is reliable evidence to show that Chinese medicine is safe in trained hands, but not in untrained hands (Acupuncture – MacPherson & White 2001, MacPherson 2004: Herbal Medicine – Denham 1999). This is supported by the Medicines and Healthcare products Regulatory Agency (MHRA), the House of Lords’ Select Committee for Science and Technology and Department of Health’s own Steering Group.
Even in well-trained practitioners (ie those trained in the subject to minimum first degree level) there is an issue of public safety if practitioners are not regulated.
Answer to Q2:
Statutory regulation would be of great benefit by setting a consistent level of training. There is evidence to show that adverse events are more likely to occur where practitioners had completed a short course rather than a full training (Bensoussan & Myers 1996).
Statutory regulation also addresses the broader concerns about public safety, which are:
potential abuse of patients
lack of peer review to maintain standards
Statutory regulation would decrease risk to patients by:
establishing competence at degree level
ensuring quality assurance for herbal medicines
ensuring practitioners’ compliance with standards of conduct, performance and ethics
CRB checks could be enforced
The current situation of voluntary regulation only works for those who are prepared to take part. Those who do not are the ones who pose the risk. To protect the public the government should regulate.
Question 3
What do you envisage would be the benefits to the public, to practitioners, and to businesses, associated with introducing statutory regulation?
Question 4
What do you envisage would be the regulatory burden and financial costs, to the public, to practitioners, and to businesses, associated with introducing statutory regulation? Are these costs justified by the benefits and are they proportionate to the risks? If so, in what way?
Answer to Q3:
Benefits to general public, NHS providers and health insurers of statutory regulation would be that they would be able to identify safe, well-trained practitioners
There would be greater consistency of standards and it would be clearer what can be expected. This is in accordance with patients’ wishes (Thomson 2005)
In 2007 the Department of Health said that ‘The Government is committed to the statutory regulation of herbal medicine, acupuncture and traditional Chinese medicine practitioners … probably in 2008/0’ (DH 2007b). Those who embarked on a career on this basis should be able to rely on the information they have been given
Answer to Q4:
Probably little cost outside development of the regulatory framework
Question 5
If herbal and TCM practitioners are subject to statutory regulation, should the right to prepare and commission unlicensed herbal medicines be restricted to statutorily regulated practitioners?
Question 6
If herbal and TCM practitioners are not statutorily regulated, how (if at all) should unlicensed herbal medicines prepared or commissioned by these practitioners be regulated?
Question 7
What would be the effect on the public, practitioners and businesses if, in order to comply with the requirements of European medicines legislation, practitioners were unable to supply manufactured unlicensed herbal medicines commissioned from a third party, after 2011?
Answer to Q5:
Yes, primarily for safety reasons.
Answer to Q6:
Only statutory regulation of practitioners will ensure safety of practitioners and of herbal medicines.
Answer to Q7:
A serious loss of a valuable resource for patients, who would then be tempted to source products online with considerably increased risk.
Question 8
How might the risk of harm to the public be reduced other than by statutory professional self-regulation? For example, by voluntary self-regulation underpinned by consumer protection legislation and by greater public awareness, by accreditation of voluntary registration bodies, or by a statutory or voluntary licensing regime?
Question 9
What would you estimate would be the regulatory burden and financial costs, to the public, to practitioners, and to businesses, for the alternatives to statutory regulation suggested at Question 8?
Question 10
What would you envisage would be the benefits to the public, to practitioners, and to businesses, for the alternatives to statutory regulation outlined at Question 8?
Answer to Q8:
Alternatives to statutory regulation from the discussions of the EPR Working Group and its consultation paper:
Voluntary Self-Regulation
Pros:
· Easily responds to requirements for change (compared with statutory regulation)
1 Strong sense of ownership by members
2 Offers public information
3 Robust systems already in place in the form of BAcC and EHTPA
Cons:
Association has to be trusted to maintain standards
No obligation to join the association, so unless there is protection of function as well as title, those who are not members may continue to practice under a different banner
Existing legislation for health and safety, trading standards and advertising/Local Authority Registration and Licensing
Neither of the above are sufficiently comprehensive solutions on their own but could be used in conjunction with one of the others.
Statutory Licensing Schemes
Voluntary Licensing Schemes
Protection of title has the advantage of giving ease of identification to the public
In summary, there is no suitable alternative to statutory regulation. None of the above combine the impartiality and standard setting afforded by an effective statutory register (DH 2007a).
Answer to Q9:
Costs to patients would be higher.
Costs to herbal suppliers complying with standards would be higher and they would be undercut by those who did not comply
Costs to MHRA would increase
Answer to Q10:
No advantage
Question 11
If you feel that not all three practitioner groups justify statutory regulation, which group(s) does/do not and please give your reasons why/why not?
Answer to Q11:
It is crucial that all three groups are statutorily regulated (professional acupuncturists, herbalists, TCM practitioners)
Question 12
Would it be helpful to the public for these practitioners to be regulated in a way which differentiates them from the regulatory regime for mainstream professions publicly perceived as having an evidence base of clinical effectiveness? If so, why? If not, why not?
It is essential that the evidence base for Chinese medicine is well established, in the same way as with all healthcare available to the public, for the following reasons:
Easier to identify those practitioners who have a clear awareness of the evidence base for their practice
Increased safety for the patient
Easier dialogue between healthcare practitioners
For this reason adequate funding should be made available.
Question 13
Given the Government’s commitment to reducing the overall burden of unnecessary statutory regulation, can you suggest which areas of healthcare practice present sufficiently low risk so that they could be regulated in a different, less burdensome way or de-regulated, if a decision is made to statutorily regulate acupuncturists, herbalists and traditional Chinese medicine practitioners?
I am not qualified to speak of other professions aside from Chinese medicine.
However, from the patient’s point of view, the ability to identify a qualified practitioner is not a burden but part of the trend in society for greater transparency in the provision of information.
This also enables regulated healthcare practitioners to identify qualified practitioners.
Question 14
If there were to be statutory regulation, should the Health Professions Council (HPC) regulate all three professions? If not, which one(s) should the HPC not regulate?
Question 15
If there were to be statutory regulation, should the Health Professions Council or the General Pharmaceutical Council/ Pharmaceutical Society of Northern Ireland regulate herbal medicine and traditional Chinese medicine practitioners?
Question 16
If neither, who should and why?
Answer to Q14:
Yes, HPC should regulate all three.
Question 17
a) Should acupuncture be subject to a different form of regulation from that for herbalism and traditional Chinese medicine? If so, what?
b) Can acupuncture be adequately regulated through local means, for example through Health and Safety legislation, Trading Standards legislation and Local Authority licensing?
Answer to Q17a:
No. This would lead to confusion on the part of any patient of traditional Chinese medicine practitioners who practice both acupuncture and herbal medicine – an increasing proportion.
It would lead to significant difficulties if a patient were to try to make a complaint.
Answer to Q17b:
No.
Question 18
a) Should the titles “acupuncturist”, “herbalist” and “[traditional] chinese medicine practitioner” be protected?
b) If your answer is “No”, which ones do you consider should not be legally protected?
Yes.
Question 19
Should a new model of regulation be tested where it is the functions of acupuncture, herbal medicine and TCM that are protected, rather than the titles of acupuncturist, herbalist or Chinese medicine practitioner?
No, a new model would be unhelpful and unnecessary. The titles should be protected.
Question 20
If statutory professional self-regulation is progressed, with a model of protection of title, do you agree with the proposals for “grandparenting” set out in the Pittilo report?
Answer to Q20:
Yes. The aim of the proposals was to ensure that as many existing practitioners as possible would apply for entry to the register as this would be in the interests of public safety.
Question 21
In the event of a decision that statutory or voluntary regulation is needed, do you agree that all practitioners should be able to achieve an English language IELTS score of 6.5 or above in order to register in the UK?
Question 22
Could practitioners demonstrate compliance with regulatory requirements and communicate effectively with regulators, the public and other healthcare professionals if they do not achieve the standard of English language competence normally required for UK registration? What additional costs would occur for both practitioners and regulatory authorities in this case?
Question 23
What would the impact be on the public, practitioners and businesses (financial and regulatory burden) if practitioners unable to achieve an English language IELTS score of 6.5 or above are unable to register in the UK?
Answer to Q21:
Yes. Good English language standards are essential to communication with patients.
Answer to Q22:
No, they could not demonstrate compliance.
Answer to Q23:
Practitioners who cannot communicate in English would not be allowed to practice
Question 24
Are there any other matters you wish to draw to our attention?
Your chance to say whatever you feel.
References:
Bensoussan A, Myers P 1996 Towards a Safer Choice: the Practice of Chinese medicine in Australia. Department of Human Services: Victoria, Australia (online) last accessed 6 Oct 2009 at URL http://www.health.vic.gov.au/archive/archive2006/chinese/index.htm
Denham A 1999 The 1968 Medicines Act- Schedule 3 herbs, and their use by practitioners. European Journal of Herbal Medicine 4:19-28
Department of Health (DH) 2007a Trust Assurance and Safety – the Regulation of Health Professionals in the 21st Century CM7013. The Stationery Office: London
Department of Health (DH) 2007b Statutory regulation of herbal medicine, acupuncture and traditional Chinese medicine practitioners. Human resources and training, workforce update (online) last accessed 4 Oct 2009 at UEL http://www.dh.gov.uk/en/Managingyourorganisation/Humanresourcesandtraining/Browsable/DH_5835963
MacPherson H, Thomas K, Walters S, Fitter M 2001 A prospective survey of adverse events and treatment reactions following 34,000 consultations with professional acupuncturists. Acupuncture in Medicine 19(2):93-102
MacPherson H, Scullion A, Thomas K, Walters S 2004 Patient reports of adverse events associated with acupuncture treatment: a prospective national survey. Qual Saf Health Care 2004: 13(5): 349-355
Thomson A 2005 A healthy partnership: integrating complementary healthcare into primary care. The Prince of Wales’s Foundation for Integrated Health: London.
You’re never too old for a change of career
At LCTA, there is no age limit on studying as one third year acupuncture student who is 74 years old will testify:
I worked in a variety of jobs when I was younger. I’ve always tried to keep busy and when we retired my husband and I decided to move to Mallorca. We bought a ruin and restored it over the next few years and because my brain constantly needs to be working, I learnt Spanish at the same time.
I decided to begin studying again because I thought I would become brain-dead if I didn’t do something. The last bit of serious studying I had done was in 1994 when I did a counselling and psychotherapy course. The course was a great way to train my listening skills and I really enjoyed it, but ten years later I needed a new challenge.
I was trying to work out what I wanted to do and looked at a variety of options. I had always been interested in healing and having grown up in the West Indies I was used to the concept of having someone at home who was involved in healing in some way. Where I grew up, you never just went to the doctor. My grandmother and my father were both healers and part of a strong tradition of people looking after each other. So I decided to look into how I could develop my own skills in healing and became really interested in Traditional Chinese Medicine.
As well as being accessible, LCTA was the friendliest of all the colleges I looked at and I liked the sound of the course. Everyone was charming at the Presentation Day and they really put me at ease during my interview. Although I hadn’t done any serious studying for a while, when I began the course, it wasn’t too much of a shock to the system, but the essays and exams are hard. Everyone else is in the same boat though, so we help each other through it.
I’d like to practise in Mallorca and I have to look into all the legalities of setting up over there and make sure that I have the correct qualifications. I will only practise part time but definitely plan to practise over there. You are never too old to study or change career. Lots of people think it’s daunting to do something like this at my age – they think it’s quite amazing. But it’s not such a bad idea and it’s certainly not particularly unusual.
I’m thoroughly enjoying the course, it’s really interesting. The whole concept of TCM fascinates me – it hasn’t lost any of its appeal over the millennia. The course has pulled my brain together again – it definitely sharpens you up. You constantly have to meet deadlines and those grey cells that have been mouldering away in the corner have to pick themselves back up again and get back to serious work.
When I chose to study acupuncture, I didn’t take the easy option. It’s proven to be a real challenge, a lot of hard work and a truly enlightening experience. Being a bit older doesn’t make any difference. It’s a fantastic experience; anyone who is interested in TCM should go for it – no matter what their age!
