As the name suggests, Traditional Chinese Medicine (TCM) originated in China, and its various therapeutic practices were developed over thousands of years. Generally speaking, CM comprises various mind and body practices, as well as herbal remedies, with the aim of treating and preventing a range of different health problems.
In the United States for example, people use CM primarily as a complementary health approach. As such, CM is often shrouded in a level of mystery, and society at large is unfamiliar with the theory behind the practice.
A team of experts from the Chinese University of Hong Kong, who specialize in CM, want to change that. Their new online course, "Everyday Chinese Medicine", purposes to demystify the ancient practice of CM and is specifically designed for the general public.
The team is headed up by Professor Vincent Chung. Recently, we interviewed Chung about his new MOOC (massive open online course).
"We Want to Promote Awareness of Chinese Medicine"
Edukatico: Professor Chung, why is Chinese medicine an important topic for today’s medical practitioners and society at large?
Professor Chung: With the increasing interest in and usage of traditional medicine (TM) worldwide, it is recognized that public education is key to promoting safe and effective use of TM in the community.
The World Health Organization Traditional Medicine Strategy 2014-23 specified that practitioners must ensure consumers can make informed choices about self-health care, and practitioners must promote proper use of TM products and services.
CM is one of the major forms of TM used worldwide. Our MOOC aims to serve as an educational platform to teach and inform the general public about CM. Our primary goal is to empower healthcare choices by promoting awareness of CM diagnostic and therapeutic approaches. The course also serves as an introduction to CM for healthcare professionals, such as physicians trained in biomedicine, nurses, allied health professionals, and pharmacists.
Edukatico: You mentioned that your course aims to "serve as an educational platform". Could you summarize the main topics participants in the course will learn about?
Professor Chung: The course aims to familiarize the public, as well as healthcare professionals, with the basic principles of Chinese Medicine.
As I mentioned earlier, our primary goal is to empower healthcare choices by promoting awareness. But we also desire to facilitate education on an inter-professional level, as in, between Chinese and conventional health care providers.
Learners will also develop skills in terms of applying the theories of CM to understanding health and illness. We will discuss how CM conceptualizes health through the relationship between Yin Yang — how the Zang-Fu organs maintain the vital functions of the human body, and how Qi, Blood and Body Fluids contribute to well-being.
We will also describe the principles of pathogenesis in CM; explaining how the six exogenous agents, seven emotions, and other pathogenic factors can lead to instances of illness. Based on such understanding, we will then demonstrate the practical diagnostic procedures in CM, using the Four Examinations, and illustrate how the syndrome differentiation process provides a basis for formulating treatment strategies in CM.
There are exercises and tasks in each session too, that facilitate better understanding of the practical principles of CM.
Edukatico: Who would be most likely to benefit from your online course and why? Is there a specific learner profile for the course?
Professor Chung: The course will appeal to anyone who is interested in this ancient practice. In addition, it also serves as an introduction for healthcare professionals.
Teaching the ancient traditions of Everyday Chinese Medicine
Chinese and Western Medicine: Mutual Understanding is Important
Edukatico: In the first part of the course learners will "compare views from Chinese and western medicine perspectives". Could you give an example of where there is a working synergy between the two?
Professor Chung: Currently, CM and conventional clinicians work as parallel professionals. The synergy of integrating best practices will not materialize unless the two professions work closely in a patient centered manner.
One of the pre-requisites for inter-professional collaboration between CM and conventional clinicians is a mutual understanding of the key principles in physiology and pathology from both perspectives.
For example, in conventional medicine, the brain is responsible for maintaining normal mental and cognitive capacity. In CM, the heart (not the anatomical equivalent in biomedicine but a system of diverse physiological functions) oversees these capacities. This explains why biomedicine and CM would take a very different diagnostic and therapeutic approach to managing mental health issues. A mutual understanding of such differences is required for synergistic collaboration between the two professions.
Edukatico: In the second part of the course, participants will learn to "apply appropriate CM self-care practice". Can you explain how individuals can, using what they have learnt about self-care in this course, work along with their doctor for better health outcomes?
Professor Chung: In CM, lifestyle factors play a major role in the cause of disease. The course will explain how lifestyle modifications, including those related to diet, sleep, exercise and mindfulness, may help in the prevention of disease. The course will also enable learners to appreciate the complexity of the CM diagnostic framework, allowing better communication between CM clinicians and their patients.
Edukatico: We would like to know what your expectations are regarding teaching an online version of this course. What are the main differences and benefits associated with teaching it online, as opposed to teaching it on campus?
Professor Chung: As an introductory course in basic CM theory, online teaching has the merit of allowing the dissemination of knowledge to a global audience in a structured format. It is a good starting point for the public as well as healthcare professionals who are interested in pursuing more hands-on learning in CM, which would otherwise be best conducted in a campus or clinical setting.
Varying Degrees of TCM Integration Into Existing Health Care Systems Around the World
Edukatico: Lastly, learners from many different countries will participate in the course. Could you describe the current status of CM around the world? Are there countries where it is more widely used and accepted, or countries where it is not?
Professor Chung: Traditional medicine (TM), including CM, has long played a role in many of the world's health care systems and is increasingly popular today. Along with ancient Indian, Greek and Egyptian medicine, CM is one of the four major traditional medicine systems in human history.
In many Asian countries TM is an integral part of the healthcare system; the usage and practice of TM is deeply rooted in the social and cultural fabric of the community. In resource poor regions like Africa, it is estimated that 80 percent of the population depend on TM for basic healthcare. Meanwhile in the West, populations from middle and high-income countries have increasingly turned to "complementary and alternative medicine" (CAM) in the past 20 years. Figures for lifetime use of CAM in populations such as those of the UK and Australia were 47 and 48 percent respectively, while the figures for Canada and Chile are approaching 70 percent.
The U.S. National Center for Complementary and Alternative Medicine (NCCAM) has defined TM and CAM as "a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine". The use of "conventional" in this definition denotes the incompatibility between the holistic paradigm of TM/CAM, and the reductionist biomedical paradigm of biomedicine.
Policy initiatives have, however, been initiated to integrate the different modalities. For example, the WHO´s latest Traditional Medicine Strategy specified priority actions for governments to advance TM/CAM policy; including ensuring the regulation, rational use, access, safety, efficacy and quality of TM/CAM services.
The growing popularity of traditional and alternative medicine with patients has encouraged research into the combination of different modalities of care. However, effective integrated policy making is lagging behind. A global survey indicated that only 66 out of 213 member states of the WHO have implemented a TM/CAM policy within their health systems.
The health system of China is considered by the WHO as one of the four in the world that has achieved the highest degree of integration between biomedicine and TM/CAM; alongside Vietnam, South Korea and North Korea. In China, about 12 percent of all licensed clinicians are CM practitioners, delivering 10 to 20 percent of all healthcare in the country, with over 200 million and 7 million episodes of outpatient and inpatient service utilizations respectively.
In most health centers and clinics, CM and biomedicine are practiced alongside each other. About 75 percent of all health centers have a CM or integrated Chinese biomedicine department and about one third of the total service provisions in these centers were provided by CM practitioners.
The Chinese government passed the Traditional Chinese Medicine Ordinance in April 2003. Subsequently, policies for promoting TCM were promulgated. These policies are synchronized with the primary care emphasis in the Chinese healthcare reform agenda. It is proposed that, (1) more Chinese herbal medicines will be included in the essential medicines list; (2) the associated reimbursement rates for CM services will be increased in the social health insurance scheme; (3) stronger funding and support for CM services will be offered to county level hospitals, as well as public hospitals; (4) stronger specialist family medicine training will be provided to CM practitioners; and (5) research on CM will be supported to strengthen the CM evidence base.
Edukatico: Thank you for this overview and all the best for your MOOC!
The "Everyday Chinese Medicine" course launches on the Coursera platform on October 23, 2017.
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