- Joined
- Jan 23, 2010
- Messages
- 1,746
- Points
- 0
Feb 1, 2011
TCM 'specialists' label risks confusing patients
It's still a complementary field of medicine here and should be treated as such
By Grace Chua
TRADITIONAL Chinese medicine (TCM) has been a hot subject of debate in the Forum pages of this newspaper and on other fora after the Ministry of Health (MOH) said last month there is no such thing as a TCM specialist, and that it would investigate practitioners here who misuse that term.
Health Minister Khaw Boon Wan explained that a specialists' register for TCM practitioners could be worked out in future, but it would take time before the industry reaches a standard of professionalism similar to that of Western doctors here.
On Sunday, he revealed he had tasked a group of senior TCM professionals to look at where the profession should be in five years.
To look at its future, this group will first have to come to grips with where it is today. In Singapore, TCM is a long-standing part of local Chinese culture. Many - including non-Chinese patients - visit the sinseh (Chinese doctor) or acupuncturist. There are about 2,400 registered practitioners here.
Many treat it as complementary to Western medicine, and there are TCM clinics located at Singapore General Hospital and Nanyang Technological University.
But regulation has come only recently. The TCM Practitioners Act, the industry's equivalent of the Medical Registration Act, was passed only in 2000, and registration of acupuncturists and physicians came in the following years. Physicians must be registered and adhere to ethical guidelines.
These requirements have led some to ask why TCM practitioners with many years of practice cannot also describe themselves as specialists. But the topic of medical specialities is understood and regulated in a completely different way in Western medicine. Having a TCM register of specialists may complicate matters and not be relevant in raising the standards of the industry.
Unlike in Western medicine, TCM has no uniform training system for physicians to specialise in a particular disease or organ, as TCM, by definition, is concerned with whole-body internal medicine.
A TCM physician can work with heart patients or diabetes patients for many years, but still will not have the qualifications to call himself a specialist - as there are none. Hence, those who would call themselves TCM specialists are misleading patients, explained Professor Ng Han Seong, a gastroenterologist.
Prof Ng is also registrar of the TCM Practitioners Board which, like the Singapore Medical Council (SMC), oversees registration and discipline of its practitioners.
Western medical practitioners here can call themselves specialists only if they have obtained specific qualifications. For example, a general practitioner who does aesthetic procedures is not allowed to call himself a dermatologist unless he takes an exam and gets a qualification from a list of recognised institutions.
There are some rules for TCM practitioners too. Like Western doctors, they must get specific qualifications from a list of recognised institutions and have working experience. In addition, they must pass a registration exam.
And both Western doctors and TCM practitioners can be disciplined by their respective governing councils for breaches like prescribing drugs inappropriately.
In this respect, one can argue there already exists a good framework to regulate the practice of TCM. Patients with a complaint about a practitioner can go to the TCM Board. If overcharged by TCM physicians calling themselves specialists, patients can go to the Consumers Association of Singapore (Case).
To raise the standards of TCM care, the TCM review group should decide what it wants the industry to achieve. Should it remain complementary to conventional medicine? Should it be integrated with conventional medicine as in China, where TCM practitioners and conventionally trained doctors work side by side on the same patients? If so, what working knowledge of each other's practices should members of each industry have?
If the group wants to consider the feasibility of having a specialists' register, it would have to look at qualifications and training for specialists.
Categorisation of specialities may have to differ from the Western practice of delineating by body part or function: Not a heart specialist, for example, but a specialist in, perhaps, TCM geriatric care.
The issue of specialisation in TCM is so complicated that a Forum page letter- writer, Dr Ong Siew Chey, a retired surgeon and author of a book on Chinese history and culture, suggested that MOH is barking up the wrong tree in proposing such a register.
He wrote: 'It is not right that one school (of medicine) requires scientific proof and evidence for its practice and is held responsible for possible errors, while the other is exempt from the need for scientific scrutiny and is free of legal responsibility of the outcome.'
The TCM Practitioners Board responded that its practitioners are not exempt from the duty to provide proper care according to their system of medical practice.
But Dr Ong may have a point in suggesting that registration and maintaining a register of specialists may confer upon TCM a degree of legitimacy and credibility it may not yet possess.
As it is practised in Singapore today, it is 'pure' traditional medicine, cleaving to traditional philosophies, diagnostic techniques, treatment methods and herbal medicines. Physicians cannot prescribe Western drugs or conduct surgery.
Herbal products used in TCM do have their uses. For instance, they can help alleviate the side effects of chemotherapy.
The practice of TCM has significant historical and cultural value. In Singapore, it is a widely accepted practice. Recent years have seen the establishment of a framework to register practitioners, raise standards and regulate the industry.
But TCM remains a complementary field of medicine and should be treated as such. Forbidding TCM practitioners from self-styling themselves as 'specialists' is a start. Coming up with a register may merely confuse matters.
[email protected]
TCM 'specialists' label risks confusing patients
It's still a complementary field of medicine here and should be treated as such
By Grace Chua
TRADITIONAL Chinese medicine (TCM) has been a hot subject of debate in the Forum pages of this newspaper and on other fora after the Ministry of Health (MOH) said last month there is no such thing as a TCM specialist, and that it would investigate practitioners here who misuse that term.
Health Minister Khaw Boon Wan explained that a specialists' register for TCM practitioners could be worked out in future, but it would take time before the industry reaches a standard of professionalism similar to that of Western doctors here.
On Sunday, he revealed he had tasked a group of senior TCM professionals to look at where the profession should be in five years.
To look at its future, this group will first have to come to grips with where it is today. In Singapore, TCM is a long-standing part of local Chinese culture. Many - including non-Chinese patients - visit the sinseh (Chinese doctor) or acupuncturist. There are about 2,400 registered practitioners here.
Many treat it as complementary to Western medicine, and there are TCM clinics located at Singapore General Hospital and Nanyang Technological University.
But regulation has come only recently. The TCM Practitioners Act, the industry's equivalent of the Medical Registration Act, was passed only in 2000, and registration of acupuncturists and physicians came in the following years. Physicians must be registered and adhere to ethical guidelines.
These requirements have led some to ask why TCM practitioners with many years of practice cannot also describe themselves as specialists. But the topic of medical specialities is understood and regulated in a completely different way in Western medicine. Having a TCM register of specialists may complicate matters and not be relevant in raising the standards of the industry.
Unlike in Western medicine, TCM has no uniform training system for physicians to specialise in a particular disease or organ, as TCM, by definition, is concerned with whole-body internal medicine.
A TCM physician can work with heart patients or diabetes patients for many years, but still will not have the qualifications to call himself a specialist - as there are none. Hence, those who would call themselves TCM specialists are misleading patients, explained Professor Ng Han Seong, a gastroenterologist.
Prof Ng is also registrar of the TCM Practitioners Board which, like the Singapore Medical Council (SMC), oversees registration and discipline of its practitioners.
Western medical practitioners here can call themselves specialists only if they have obtained specific qualifications. For example, a general practitioner who does aesthetic procedures is not allowed to call himself a dermatologist unless he takes an exam and gets a qualification from a list of recognised institutions.
There are some rules for TCM practitioners too. Like Western doctors, they must get specific qualifications from a list of recognised institutions and have working experience. In addition, they must pass a registration exam.
And both Western doctors and TCM practitioners can be disciplined by their respective governing councils for breaches like prescribing drugs inappropriately.
In this respect, one can argue there already exists a good framework to regulate the practice of TCM. Patients with a complaint about a practitioner can go to the TCM Board. If overcharged by TCM physicians calling themselves specialists, patients can go to the Consumers Association of Singapore (Case).
To raise the standards of TCM care, the TCM review group should decide what it wants the industry to achieve. Should it remain complementary to conventional medicine? Should it be integrated with conventional medicine as in China, where TCM practitioners and conventionally trained doctors work side by side on the same patients? If so, what working knowledge of each other's practices should members of each industry have?
If the group wants to consider the feasibility of having a specialists' register, it would have to look at qualifications and training for specialists.
Categorisation of specialities may have to differ from the Western practice of delineating by body part or function: Not a heart specialist, for example, but a specialist in, perhaps, TCM geriatric care.
The issue of specialisation in TCM is so complicated that a Forum page letter- writer, Dr Ong Siew Chey, a retired surgeon and author of a book on Chinese history and culture, suggested that MOH is barking up the wrong tree in proposing such a register.
He wrote: 'It is not right that one school (of medicine) requires scientific proof and evidence for its practice and is held responsible for possible errors, while the other is exempt from the need for scientific scrutiny and is free of legal responsibility of the outcome.'
The TCM Practitioners Board responded that its practitioners are not exempt from the duty to provide proper care according to their system of medical practice.
But Dr Ong may have a point in suggesting that registration and maintaining a register of specialists may confer upon TCM a degree of legitimacy and credibility it may not yet possess.
As it is practised in Singapore today, it is 'pure' traditional medicine, cleaving to traditional philosophies, diagnostic techniques, treatment methods and herbal medicines. Physicians cannot prescribe Western drugs or conduct surgery.
Herbal products used in TCM do have their uses. For instance, they can help alleviate the side effects of chemotherapy.
The practice of TCM has significant historical and cultural value. In Singapore, it is a widely accepted practice. Recent years have seen the establishment of a framework to register practitioners, raise standards and regulate the industry.
But TCM remains a complementary field of medicine and should be treated as such. Forbidding TCM practitioners from self-styling themselves as 'specialists' is a start. Coming up with a register may merely confuse matters.
[email protected]
