Who’s Who: Part II

You have choices when it comes to your health care. The options may not be covered by insurance but you still have the choice to pursue care and support for your health as it aligns with your needs and values. I often encounter confusion from people about these care alternatives and I’d like to help define them, from my perspective, so what they offer may seem less obscure and more approachable. Part II, the final in this post series, focuses on modalities of care outside of Western medicine.

Before the emergence of Western medicine health was supported by a number of traditional medical practices used for years and, for some, millennia. The utility of these practices may not be predicated on the randomized, double-blind, placebo-controlled studies epitomized in conventional medicine today, but a foundation built on so many years of observation and trial and error most certainly counts for something and should not be discredited simply because they do not fit into the current paradigm. Medicine as we know it today is in its infancy compared to these traditional practices and it is my opinion, as well as my clinical experience, that there is value in these “unconventional” methods that were, for the majority of our human existence, a standard.

Traditional Chinese/Eastern Medicine has thousands of years of existence and was largely introduced to the US in the 1970s. It is an energetic medicine that incorporates alternative diagnostic tools such as tongue appearance and pulse patterns and utilizes acupuncture, herbs, movement, and diet as treatment tools to restore energy balance in a person.  Not all acupuncturists use herbs and not all TCM practitioners practice acupuncture. Practicing acupuncture requires separate licensure in most states and you may see the LAc title independently or coupled with other designations: LAc DAOM (doctorate level), MD LAc, ND LAc, etc. In some states such as California and Florida, LAcs are licensed as primary care providers allowing them to order blood work and make treatment recommendations beyond acupuncture and TCM. Acupuncture has gained recognition as a valuable tool for pain, anxiety, and infertility but its benefits extend far beyond these issues and it is a worthwhile consideration for many health issues.

Education:  Levels of education in TCM vary.  Most programs are 3-4 years long. Doctorate programs may be completed online or in-person, offering an additional one to two years of education in more integrative and/or specialty care.

Ayurvedic Medicine originated in India and uses diet, lifestyle, and herbs to align a person’s unique dosha, or energetic constitution. Doshas comprise three energy states – vata, pitta, and kapha – with one state generally predominating the others for each person. In a very simplified version of the Ayurvedic philosophy, it is thought that an imbalance in this innate energy pattern gives rise to physical ailments and treatment is targeted to bring the body state in alignment with one’s personal dosha to support health.  Especially when it comes to digestive issues, I have found the Ayurvedic approach a helpful piece for many patients.

Education:  Certificate levels vary. According to the National Ayurvedic Medical Association, there are Ayurvedic counselors, practitioners, and doctors with a minimum of 600, 1500, and 3000 hours of training, respectfully. The latter two do receive some training in western medicine, more-so for the doctor-level education. There are currently no licensure laws for Ayurvedic practitioners defining a scope of practice.

Homeopathy originated in the 19th century along with other eclectic medical practices.  It is an energetic practice based on the principle of like-cures-like and uses infinitesimal amounts of a substance as treatment. It is the energy of the substance that imparts the treatment, not the substance itself. As an example, if you were stung by a bee a homeopath may choose to dose you with bee venom that’s been diluted in water up to a factor of 10-2000 with a single drop of that placed onto a small sugar pellet to be taken orally (hence homeopathy’s infamy as a placebo/sugar pill or otherwise useless treatment). However, in homeopathy, the more dilute a substance the more powerful it is at eliciting a response since it works with energetics which do not follow that same principals as physical substances. The bee venom example is an acute application of homeopathy and does not represent the more complex system of classical/constitutional homeopathy practiced by most homeopaths. Naturopathic doctors are not homeopaths and homeopaths are not NDs, but the naturopathic education does include coursework in homeopathy as a non-pharmacologic treatment tool; some practitioners use it often and others not at all. Personally, I do not feel the 2% stake it had in our education (a true statistic) made any of us experts in it. True practitioners of the craft have invested additional time and education on the subject to make it a meaningful part of their practice. As naturopathic doctors, we were taught homeopathy as a complimentary treatment and never a replacement for conventional care unless deemed safe, but I cannot say the same for practitioners of homeopathy without a medical license. I have seen homeopathy be a wonderful tool in health and especially so for children, older adults, emotional trauma, or peculiar, stubborn cases.

Education: in the naturopathic medical education there are 24 in-class hours dedicated to homeopathy.  Professional homeopathy programs exist such as the New England School of Homeopathy that provide more in-depth education and are open to the public.  No education prerequisites required. 

Energetics are the common thread among these traditional practices. There are many other forms of energeticl medicines available but I chose to focus on the more familiar practices here. In my clinical experience I can say that addressing an energetic component has been THE thing that finally helps someone overcome a chronic health or emotional issue. As long as no harm is done by ignoring life-saving standards of care (in many instances patients who seek traditional medicines have already tried – and failed – conventional treatments) these approaches are worthy of recognition and I don’t need a precise understanding of how they work for me to apply them. This energetic component of health is an aspect conventional medicine will never recognize or value and it does a disservice to us all. Traditional and conventional practices approach health from two different platforms and there is room for them to coexist, often with superior outcomes.

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