In Oriental Medicine/Acupuncture Schools you are taught the importance of referring to other medical professionals. Literally one-third or more of your several thousand hours of training focuses on identifying ‘red flags’ and other symptoms, conditions, or scenarios that are believed to require care and treatment outside of the acupuncturist’s scope of practice. The reasoning here seems good: teach the acupuncturists how to identify conditions that may require further diagnostics or treatments we cannot provide. In many cases this strategy is a good one. It seems to have the patient’s best interest in mind. Of course it assumes that the referred MD/DO is competent, which is often not the case.
I have been working in Oriental medicine in some form since 1997, and my experience is very much the opposite of what I describe above, and opposite of the material presented during formal education.
In my world as an internal medicine specialist within Oriental Medicine, I find that I am rarely first to see patients. I am usually last… as in “last chance corral”. Maybe it’s because doctors take insurance and I do not. Maybe it’s because MD’s are accepted in the mainstream and I am not. Maybe it’s because that’s the cultural training: go to your MD. If that doesn’t work then figure out the next step… Maybe it’s some combination of all the above. I am not sure, but it is a consistent scenario nonetheless.
My experience with patients who come to see me for “real” problems (rather than minor aches or pains or other minor complaints) is that they almost always come with a story. These stories typically have one or more of the following elements:
- My doctor misdiagnosed me.
- My doctor did not diagnose me, but provided a treatment requiring a diagnosis (very common — for example: prescribing antibiotics without verifying a bacterial infection).
- My doctor’s treatment didn’t work.
- I have more problems after the treatment, and my doctor won’t call me back.
- My doctor’s treatment worked for the main symptom, but now I feel much worse and have other problems.
- Nobody seems to understand my problem.
- Nobody has answered any of my questions.
- I wanted to schedule a follow-up visit, and the next available time was in three weeks.
- I seem to be getting more sick.
So strange. Learning to be an effective Oriental medicine specialist in this culture comes with some significant challenges. Learning how to have a patient’s back, as it were, while not stepping on the toes of other professionals is a real trick. I find myself in this position often. Well, as long as I can help then I am happy to do it. It is ironic, however. I find myself often in a push/pull situation regarding my relationship with our culture as related to my work. People will likely never call me until it’s a real problem and the Western medical community has not helped, and then suddenly I’m of some value.
The schools try to be realistic in their training of new practitioners, but it seems that they are pretty far from reality. Maybe they should do more to prepare students for the difficulties and stresses of being the last chance guy for real health problems while being effectively “off the grid” of the medical community.