Author: Arthur Yin Fan

POSITION LETTER

ON FDA BLUPRINT FOR PRESCRIBER EDUCATION

FOR EXTENDED-RELEASE AND LONG-ACTING OPIOIDS ANALGESICS

July 5, 2017

Ref: Docket No. FDA–2017–D–2497

We welcome the FDA’s position with regard to extended-release and long-acting opioids analgesics.  Patients need medications without severe side effects and addictive effects, as well as acupuncture, which belongs to safe, non-pharmacological therapies.

Acupuncture is an effective, cost-effective therapy without adverse side-effects.

The facts:

1. Acupuncture is a cost effective therapy¹:  
Acupuncture is a proven modality that saves thousands of dollars from pain medications when used in conjunction with a treatment plan focused on acupuncture. If using acupuncture for pain management, the patients and insurers can save money and successfully manage their pain and other symptoms without the adverse risks associated with prescription medications. Here are some examples: For post-stroke treatment, acupuncture saves $26,000 per patient; For Migraine, acupuncture saves $35,480 per patient; For Angina Pectoris, acupuncture saves $32,000 per patient; For severe osteoarthritis, acupuncture saves $9,000 per patient; For Carpal Tunnel Syndrome, acupuncture saves $4,246 per patient.

2. Clinical Efficacy: 
There are many acupuncture studies in both basic science and clinical trials, supported by National Center for Complementary and Integrative health (NCCIH) and National Cancer Institute (NCI), of the National Institutes of Health (NIH).  For the studies regarding acupuncture for pain, there are more than 7,000 articles published and documented in PUBMED or Medline. Almost all of the acupuncture studies in the basic science studies have positive results; they show that acupuncture has positive effects on the decrease of pain in both human and animal studies. Acupuncture can increase endorphins, serotonin, dopamine, and other internal neurotransmitters, and heal the course of pain (such as caused by various inflammatory, and neurogenic issues), and also directly treat the pain. For acupuncture clinical trials, most of them show that acupuncture is both safe and effective if the studies have large-enough patient samples (i.e. P<0.05). However, we should be aware of the methodology flaws, as some trial designs have obvious mistakes. For example, some researchers adopted so-called “sham acupuncture” to mimic the trials for pharmaceutic medication; they did not consider the difference between acupuncture, as an external nervous system stimulation therapy, and internal medications which requires absorbing into the blood steam to have some pharmacological actions. Most “sham acupuncture”, without validating study, is actually just one style of real acupuncture used by acupuncturists around the world. It is not a placebo. So while some people try to disregard the effectiveness of acupuncture by stating that acupuncture is just a placebo, they actually made their judgement based on a wrong term used in acupuncture clinical trials. ²

NIH reports that the data in support of acupuncture is as strong as those for many accepted Western medical therapies. In 1997 the NIH approved acupuncture as an adjunctive treatment for several conditions including pain, nausea, asthma, carpal tunnel syndrome and paralysis from stroke.  Over 500 positive clinical trials measuring the efficacy of acupuncture have been conducted in the past three decades. There are 50 systematic reviews of acupuncture in the Cochrane databases. Overall, the trend has been favorable, advocating the use of acupuncture in a clinical setting as an adjunct treatment with conventional therapies, where suitable (Witt et al. 2006). Positive studies include acupuncture treatment for low back pain, neck pain, osteoarthritis of the knee and hip, fibromyalgia, rheumatoid arthritis, TMJ, headaches, infertility, pain and nausea in cancer patients. ^1,3

Acupuncture is also effective way to treat the opioids addition, there are 32 basic studies and clinical trials included in PUBMED.⁴

3. Acupuncture is not expensive:³

Insurance coverage shows that: Federal employees have had acupuncture coverage for more than ten years (with the coverage beginning around 2006). Many other commercial healthcare insurances also have acupuncture coverage plans. Such insurance plans are aware that acupuncture is effective in pain management, and that there is solid evidence to support acupuncture as an effective therapy. Insurance coverage for acupuncture only costs a typical member’s monthly health insurance premiums of between $0.38 (0.08%) and $0.76 (0.16%) per year, based on a recent Massachusetts study.³

4. Many people are consciously deciding to choose natural therapies, including acupuncture.
People are aware that chemicals (such as those in prescription medications, especially opioids) may cause potential problems and adversely affect people’s health. More and more people are turning to natural medical therapies, like acupuncture, to avoid the adverse risks and side effects associated with pharmacologic therapies. Furthermore, patient satisfaction is incredibly high from acupuncture use.  One of the largest surveys of 89,000 U.S. acupuncture patients treated by over 6,000 acupuncturists in the American Specialty Health network found that 99% reported good, very good, or excellent service quality from licensed acupuncturists in 2014.  An impressive 93% of the respondents said that their provider was successful in treating their primary condition in 2014 and 2015.⁵

5. There has been a recent, big trend of building up integrative medicine centers in conventional medicine facilities and medical schools in the USA and around the world.
In the USA, most of the prestigious medical schools and hospitals have already had integrative medicine centers for years, including Harvard University School of Medicine and its affiliate hospitals Johns Hopkins, Cleveland Clinic, and Beth Israel in New York City. Among integrative medicine, as an important non-pharmacological therapy, acupuncture is an extensively used one. In the USA, the biggest healthcare system is the Veteran Affairs healthcare system (VA); the VA has more than 1,700 facilities as of 2015, in which 93% have established integrative medicine centers or programs which provide veterans acupuncture. In the U.S. military, many hospitals and clinics provide acupuncture service; even more, the experience of applying acupuncture has been introduced to the European military system (NATO). There are tons of news on TVs, newspapers, magazines and academic journals about the effectiveness of acupuncture. 

6. There are close to 50,000 acupuncture providers in the USA (including 34,682 active licensed acupuncturists, more than 6,000 physician acupuncturists and more than 6,000 chiropractors who adopt acupuncture in their practice). Modern acupuncture education or training and the practice provide patients an excellent resource for non-pharmaceutic pain managements and for other diseases or disorders’ treatments as well. There are already licensed and well-educated practitioners ready to serve these important groups within our population.

7.In the USA, there were about 100 million acupuncture treatments, or 25 million patients per year (estimation based on there being about 500 million acupuncture treatments per year around the world in 2015 (a survey shows at least 5 billion acupuncture needles used in that year).

In summary, acupuncture is an effective therapy, with very minor side effects, and is also effective for the treatment of opioids addiction. ATCMA strongly supports the FDA’s position on including acupuncture as a non-pharmacological therapy in the Blueprint for prescriber education for extended-release and longacting opioids analgesics.

References:

1. Acupuncture and Oriental Medicine Society of Massachusetts .Why an “Act Relative to the Practice of Acupuncture” is important: fact sheet. http://www.aomsm.org/resources/Documents/Legislature/Legislation%20relat…(link is external) 02017-2018/Acupuncture%20Insurance%20Fact%20Sheet.pdf. Accessed July 5, 2017.

2.  Fan AY. Dialogue with Dr. Lixing Lao: from a factory electrician to an international scholar of Chinese medicine. J Integr Med. 2013; 11(4): 278-284.

3. CHIA center for health information and analysis. MANDATED BENEFIT REVIEW OF H.B. 3972: AN ACT RELATIVE TO THE PRACTICE OF ACUPUNCTURE. file:///C:/Users/Arthur%20Fan/Downloads/MBR-H3972-Acupuncture%20%20CHIA%20report.pdf  Accessed July 5, 2017.

4. US National Library of Medicine National Institutes of Health,Search database. https://www.ncbi.nlm.nih.gov/pubmed/?term=opioids+addiction+acupuncture(link is external) Accessed July 5, 2017.

5.  American Specialty Health White Paper:  http://files.clickdimensions.com/ashcompaniescoma7oce/files/acupuncturec…(link is external) Accessed July 5, 2017

POSITION LETTER ON DRY NEEDLING

In terminology, dry needling is a synonym to acupuncture, just a different English translation from the original Chinese term针刺 (Zhen Ci). In China, dry needling is a common name of acupuncture for over 200 years.^(1,2)  In West, dry needling has become popular since 1980s, especially since late 1990s, for replacing the term acupuncture by some traditional and medical acupuncturists, medical doctors, as a step “toward acceptance of acupuncture by the medical profession”. ^{(3,4, 5)}

Dry needling is the use of dry needles alone, either solid filiform acupuncture needles or hollow-core hypodermic needles, to insert into the body for the treatment of muscle pain and related “myofascial” pain syndrome; a.k.a. intramuscular stimulation, trigger points (TrP) acupuncture, TrP dry needling, myofascial TrP dry needling, or biomedical acupuncture. In West, dry needling is a form of over-simplified acupuncture using biomedical language in treating “myofascial” pain, a contemporary development of a portion of Ashi point acupuncture from traditional acupuncture, an invasive practice, and is not in the practice scope of physical therapists (PTs). It seeks to redefine acupuncture by reframing its theoretical principles in a Western manner. Current dry needling protocol using filiform acupuncture needles is exact same as the acupuncture used by medical doctors in West since 1821, and same as part of Ashi point acupuncture in traditional acupuncture used in East over 2,000 years. ^(4,5) It is a medical therapy and a form of acupuncture practice, not just a technique on inserting a dry needle.

For the business of the commercial seminars, many dry needling educators have covered up their acupuncture background, and have intentionally denied the fact that dry needling is acupuncture. However, in in other situations, they did tell the truth. The Mother of dry needling, Dr. Janet Travell admitted to the general public that dry needling is acupuncture when she stated in a newspaper that “the medical way of saying it is ‘acupuncture’. In our language that means sticking a needle into somebody”, ^(5,6) and acupuncture professionals practice dry needling as acupuncture therapy and there are several criteria in the acupuncture profession to locate TrPs as acupoints.⁽⁷⁾

Dry needling issue causes many problems. Firstly, dry needling promotors have caused great confusion to academic scholars, healthcare professionals, administrators, policymakers, and the general public. As acupuncture professionals and researchers, they clearly know dry needling is acupuncture-just in different name. However, some of them made stories to fool people dry needling is different from acupuncture, and “discovered” or “developed” by themselves, or at least a “rediscovery” by western medical doctors. For example, Dr. Travell, a clinical researcher involved with acupuncture work and used to participate in the planning of acupuncture conferences ^(6,8) described a complicated dry needling “discovery processes” in her books–from injecting therapy with local anesthesia medication to  inserting injecting needle without medication–performing injecting needle dry needling, to using acupuncture needling; and used TrPs to rebrand acupoints. In fact, before had done all of these, in a newspaper she admitted to the general public that dry needling is acupuncture. This actually causes a problem in their academic integrity, although these dry needling promoters and educators are known scholars.

Secondly, in order to promote their “own” academic theory, commercial education business, and other objectives, dry needling educators have developed commercial courses for continuing education taught “dry needling techniques” to a large number of students, including PTs and other customers without acupuncture credentials in non-regulated seminars. While PTs programs do not include in any content in needling therapy,^(9,10) the national organizations of PT profession, such as APTA⁽¹¹⁾ and FSBPT⁽¹²⁾ started to support dry needling around 2010, currently there are more PTs involving the DN teaching and practice than other professionals.^(13,14) Not recognized dry needling as a part of acupuncture, PT professionals, nevertheless, made a great effort to promote dry needling practice in the past ten years in the U.S. While elevating their education level to a doctoral degree, PTs as a profession probably want to expand their scope of practice and take over dry needling, even “the physiological basis for dry needling treatment of excessive muscle tension, scar tissue, fascia, and connective tissues is not well-described in the literature.”⁽¹¹⁾ As noted, dry needling educators in both continuing education and in schools are often licensed acupuncturists.

Thirdly, dry needling has mainly been taught in continuing education level courses of 20-30 hours (proposed to increase to 54 hours in future in some program).^{(11, 13-16)}  This lack of adequate professional training increases the risk of patient’s injury and can be a threat to public health and safety. Reports of serious injuries associated with dry needling or acupuncture by PTs are not uncommon. ^(17-20) Under current healthcare regulations and system, a patient has no way to know if his or her dry needling practitioner has sufficient training and what is the risk of being injured when treated by “dry needlers” who received minimal training. More often, patients are not likely to know the practitioners’ experience level when dry needling technique is applied; nor will the patient know if the PT chooses to use needles for purposes beyond typical dry needling practice. Dr. David Simmons, a pioneer of TrPs, stated: “Your problem is largely one of semantics so the simple answer is to change the playing field and the semantics that go with it. If you… use the different terminology you leave other side without an argument”.⁽²¹⁾

How can anyone practices acupuncture under the name of dry needling and say it is not acupuncture therapy? The public has a right to expect certain hard-earned standards of accredited education and licensing for those professionals who are using acupuncture needles on them therapeutically. In most of the states of the U.S., for becoming a certified MDs acupuncturist, physician or medical acupuncturists (after they get their MD license after their western medical education and at least three years of residency) are required to get a minimum of an additional 300 educational hours in a board -approved acupuncture training institution (American Board of Medical Acupuncture, ABMA) and have 500 cases of clinical acupuncture treatments; For licensed in  acupuncture, the candidates are required to attain an average of 3,000 educational or training hours via an accredited school or program (such as The Accreditation Commission for Acupuncture and Oriental Medicine, ACAOM). ^(15,22,23) So far, there is no comparable requirements and regulations for PTs to study needling therapy and perform dry needling in the U.S. ⁽²⁴⁾ As noted that, even Dr. Travell opposes PTs to perform dry needling. ⁽⁸⁾

In addition to public risk, PT dry needlers’ denial of acupuncture recognition has created a big tension between the acupuncture profession and PTs, as well as among other professionals who are seeking to provide acupuncture by calling acupuncture in a different name. If law-makers and regulators are to decide to allow PTs and others to provide acupuncture to citizens based on only 20-30 hours of training, they can certainly do that. The historic record shows however that these lawmakers should know that they are granting them the right to practice acupuncture. ⁽²⁴⁾

ATCMA position:

In short, the evidence shows clearly that currently, at least in the U.S., dry needling practitioners intent to bypass the legal regulations to practice acupuncture in the name of dry needling.^(24,25)  We agree with the position on DN from American Medical Association (AMA):

“Dry needling is indistinguishable from acupuncture”, physical therapists and other non-physicians practicing dry needling should – at a minimum – have standards that are similar to the ones for training, certification and continuing education that exist for acupuncture.  It emphasizes that “for patients’ safety, practitioners should meet standards required for licensed acupuncturists and physicians“. ⁽²³⁾

Acknowledgements

This position letter reflects the official view of ATCMA, it was published as the 3^rd part of AAPAS White Paper 2016 (Fan AY, Xu J, Li YM. Evidence and Expert Opinions:  Drying Needling versus Acupuncture (III). Chin J Integr Med. 2017 Mar;23(3):163-165.).

REFERENCES

1. Zhu H, Most H. Dry needling is one type of acupuncture. Med Acupunct 2016;28(4):1-10. 

2. Fan AY, He H. Dry needling is acupuncture. Acupunct Med 2016;34:241.

3. Gunn CC, Ditchburn FG, King MH, Renwick GJ. Acupuncture loci: a proposal for their classification according to their relationship to known neural structures. Am J Chin Med 1976;4:183-195.

4.  Fan AY, Xu J, Li YM. Evidence and Expert Opinions:  Drying Needling versus Acupuncture (I). Chin J Integr Med. 2017; 23(1):3-9.

5. Fan AY, Xu J, Li YM. Evidence and expert opinions:  dry needling versus acupuncture (II). Chin J Integr Med 2017; 23:83-90.

6. Nichols HW. Ancient pain-killing method works, while US scientists don’t know why. Albany Democrat-Herald (Albany), March 21, 1947. www.newspapers.com(link is external).  Accessed October 3, 2016.

7. Simons DG, Travell JG, Simons LS, eds. Myofascial pain and dysfunction: the trigger point manual. 2nd ed. Baltimore: Williams &Wilkins; 1999:151-174.

8. DeLorme L. Letter to Washington State Department of Health Sunrise Reviews, Re: Sunrise Review Panel Draft Recommendations. October 10, 2016. In: Washington State Department of Health. Information Summary and Recommendations Physical Therapy Dry Needling Sunrise Review. Page 688-694. Available at: http://www.doh.wa.gov/Portals/1/Documents/2000/DryNeedlingFinal2016.pdf(link is external) Accessed Jan. 17, 2017.

9. University of Maryland Eastern Shore. Physical therapy, credit hours and approximate tuition. Available at: https://www.umes.edu/Physical-Therapy/Pages/Admissions/Estimated-Costs/(link is external) Accessed December 26, 2016.

10. University of Maryland School of Medicine. Doctor of Physical Therapy (DPT) tuition, fees and living expenses budget. file:///C:/Users/Arthur%20Fan/Downloads/2015-2016_DPT_Tuition_and_Educational_Expenses.pdf Accessed December 26, 2016.

11. American Physical Therapy Association. Description of Dry Needling In Clinical Practice: An Educational Resource Paper (2013).  http://www.apta.org/StateIssues/DryNeedling/. (link is external) Accessed July 28, 2016.

12. Federation of State Boards of Physical Therapy. FSBPT Dry Needling Resource Paper (Intramuscular Manual Therapy) 4th edition. http://www.fsbpt.org/download/dryneedlingresourcepaper_4thedition.pdf  (link is external) Accessed Dec. 10, 2016.

13. Kinetacare. Intramuscular Manual Therapy (AKA Trigger Point Needling). http://www.kinetacare.com/physical-therapy/Intramuscular-Manual-Therapy-AKA-Trigger-Point-Needling/page27.html(link is external)  Accessed Dec 10. 2016.

14.  Sportscare Physical Therapy. What is intramuscular manual therapy? http://www.sportscarephysicaltherapy.com/intramuscular-manual-therapy/(link is external)  Accessed Dec. 10, 2016

15. Fan AY, Jiang J, Faggert S, Xu J. Discussion about the training or education for “dry needling practice”. World J Acupunct Moxibust 2016;26:6-10.

16. Ma YT. Dr. Ma’s integrative dry needling. Available at: http://integrativedryneedling.com/(link is external) Accessed December 12, 2016.

17. Cummings M, Ross-Marrs R, Gerwin R. Pneumothorax complication of deep dry needling demonstration. Acupunct Med 2014;32:517-519. doi: 10.1136/acupmed-2014-010659. Epub Sep 19,2014.

18. Almloff L. Opposed two reported cases of pneumothorax by PT in Virginia have been dismissed by Board. Available at: http://www.townhall.virginia.gov/L/viewcomments.cfm?commentid=48669(link is external). Accessed December 12, 2016.

19. Knauer J. Pneumothorax from a physical therapist performing dry needling in virginia.

Available at: http://www.townhall.virginia.gov/L/viewcomments.cfm?commentid=48189(link is external). Accessed December 12, 2016.

20. Terrell W. Pneumothorax Caused by Dry Needling of Intercostal. Available at https://www.youtube.com/watch?v=EWb69O__NiE(link is external). Accessed December 12, 2016.

21. Simmons DG. Letter to the editor. J Man Manip Ther 2007t;15:246.

22. The American Academy of Physical Medicine and Rehabilitation. AAPM&R Position on Dry Needling. https://www.aapmr.org/docs/default-source/protected-advocacy/Position-Statements/aapmr-position-on-dry-needling.pdf?sfvrsn=2(link is external). Accessed Dec. 19, 2016.

23.American Medical Association. Physicians take on timely public health issues. AMA Wire. Jun 15,2016. http://www.ama-assn.org/ama/ama-wire/post/physicians-timely-public-healt…(link is external). Accessed Dec. 19, 2016.

24. Fan AY, Zheng L, Yang G. Evidence that dry needling is the intent to bypass regulation to practice acupuncture in the United States. J Altern Complement Med 2016;22:591-593.

25. Fan AY, Yang G, Zheng L. Response to Dommerholt and Stanborough re: ‘‘Evidence That Dry Needling Is the Intent to Bypass Regulation to Practice Acupuncture in the United States’’.  J Altern Complem Med.2017;23(2):150-151.

CBS News (2/13, LaPook) reports on its website that the American College of Physicians released new guidelines that says “the first line of therapy” for chronic low back pain “should be non-drug treatments.” The new guidelines recommend “heat wraps, massage, acupuncture and spinal manipulation” for pain lasting less than three months, and recommend treatments such as “stretching and strengthening exercises, tai chi, yoga, acupuncture, and mindfulness techniques” for pain lasting more than three months.

       Newsday (NY) (2/13, Ricks) reports, “The new guidelines emphasize that opioid” pain medications “should be considered only as a last resort.”
   
     The New York Times (2/13, A21, Kolata, Subscription Publication) reports that in its recommendations, the ACP “did not address surgery.” Instead, “its focus was on noninvasive treatment.” In addition, imaging “scans… for diagnosis are worse than useless for back pain patients, members of the group said in telephone interviews.” Scan “results can be misleading, showing what look like abnormalities that actually are not related to the pain.” The new guidelines (2/14) were published in the Annals of Internal Medicine.

Traditional Chinese Medicine in China

The State Council Information Office of the People’s Republic of China

December 2016

First Edition 2016

Contents

Preface

I. The Historical Development of TCM

II. Policies and Measures on TCM Development

III. Carrying Forward the Tradition and Ensuring the Development of TCM

IV. International Exchanges and Cooperation in TCM

Conclusion

Preface

Humanity has created a colorful global civilization in the long course of its development, and the civilization of China is an important component of the world civilization harboring great diversity. As a representative feature of Chinese civilization, traditional Chinese medicine (TCM) is a medical science that was formed and developed in the daily life of the people and in the process of their fight against diseases over thousands of years. It has made a great contribution to the nation’s procreation and the country’s prosperity, in addition to producing a positive impact on the progress of human civilization.

TCM has created unique views on life, on fitness, on diseases and on the prevention and treatment of diseases during its long history of absorption and innovation. It represents a combination of natural sciences and humanities, embracing profound philosophical ideas of the Chinese nation. As ideas on fitness and medical models change and evolve, traditional Chinese medicine has come to underline a more and more profound value.

Since the founding of the People’s Republic of China in 1949, the Chinese government has set great store by TCM and rendered vigorous support to its development. TCM and Western medicine have their different strengths. They work together in China to protect people from diseases and improve public health. This has turned out to be one of the important features and notable strengths of medicine with Chinese characteristics.

I. The Historical Development of TCM

1. History of TCM

In remote antiquity, the ancestors of the Chinese nation chanced to find that some creatures and plants could serve as remedies for certain ailments and pains, and came to gradually master their application. As time went by, people began to actively seek out such remedies and methods for preventing and treating diseases. Sayings like “Shennong (Celestial Farmer) tasting a hundred herbs” and “food and medicine coming from the same source” are characteristic of those years.
The discovery of alcohol in the Xia Dynasty (c. 2070-1600 BC) and the invention of herbal decoction in the Shang Dynasty (1600-1046 BC) rendered medicines more effective.

In the Western Zhou Dynasty (1046-771 BC), doctors began to be classified into four categories – dietician, physician, doctor of decoctions and veterinarian.
During the Spring and Autumn and Warring States Period (770-221 BC), Bian Que drew on the experience of his predecessors and put forward the four diagnostic methods – inspection, auscultation & olfaction, inquiry, and palpation, laying the foundation for TCM diagnosis and treatment.

The Huang Di Nei Jing (Yellow Emperor’s Inner Canon) compiled during the Qin and Han times (221 BC-AD 220) offered systematic discourses on human physiology, on pathology, on the symptoms of illness, on preventative treatment, and on the principles and methods of treatment. This book defined the framework of TCM, thus serving as a landmark in TCM’s development and symbolizing the transformation from the accumulation of clinical experience to the systematic summation of theories. A theoretical framework for TCM had been in place.

The Shang Han Za Bing Lun (Treatise on Febrile Diseases and Miscellaneous Illnesses) collated by Zhang Zhongjing in the Eastern Han Dynasty (25-220) advanced the principles and methods to treat febrile diseases due to exogenous factors (including pestilences). It expounds on the rules and principles of differentiating the patterns of miscellaneous illnesses caused by internal ailments, including their prevention, pathology, symptoms, therapies, and treatment. It establishes the theory and methodology for syndrome pattern diagnosis and treatment differentiation. The Shen Nong Ben Cao Jing (Shennong’s Classic of Materia Medica) – another masterpiece of medical literature appeared during this period – outlines the theory of the compatibility of medicinal ingredients. For example, it holds that a prescription should include at the same time the jun (or sovereign), chen (or minister), zuo (or assistant) and shi (or messenger) ingredient drugs, and should give expression to the harmony of the seven emotions as well as the properties of drugs known as “four natures” and “five flavors.” All this provides guidance to the production of TCM prescriptions, safe application of TCM drugs and enhancement of the therapeutic effects, thus laying the foundation for the formation and development of TCM pharmaceutical theory. In the late years of the Eastern Han Dynasty, Hua Tuo (c. 140-208) was recorded to be the first person to use anesthetic (mafeisan) during surgery.

The Zhen Jiu Jia Yi Jing (AB Canon of Acupuncture and Moxibustion) by Huangfu Mi during the Western Jin time (265-316) expounded on the concepts of zangfu (internal organs) and jingluo (meridians and collaterals). This was the point when theory of jingluo and acupuncture & moxibustion began to take shape.

Sun Simiao, a great doctor of the Tang Dynasty (618-907), proposed that mastership of medicine lies in proficient medical skills and lofty medical ethics, which eventually became the embodiment of a moral value of the Chinese nation, a core value that has been conscientiously upheld by the TCM circles.

A herbology and nature masterpiece, the Ben Cao Gang Mu (Compendium of Materia Medica) compiled by Li Shizhen in the Ming Dynasty (1368-1644) was the first book in the world that scientifically categorized medicinal herbs. It was a pioneering work that advanced TCM pharmaceutical theory.

The Wen Re Lun (A Treatise on Epidemic Febrile Diseases) by Ye Tianshi during the Qing Dynasty (1644-1911) developed the principles and methods for prevention and treatment of pestilential febrile diseases. It represents the theory and results of the practice of TCM in preventing and treating such diseases.

Following the spread of Western medicine in China from the mid-Qing Dynasty, especially during the period of the Republic of China (1912-1949), some TCM experts began to explore ways to absorb the essence of Western medicine for a combination of TCM with Western medicine.

2. Characteristics of TCM

During its course of development spanning a couple of millennia, TCM has kept drawing and assimilating advanced elements of natural science and humanities. Through many innovations, its theoretical base covered more ground and its remedies against various diseases expanded, displaying unique characteristics.

First, setting great store by the holistic view. TCM deems that the relationship between humans and nature is an interactive and inseparable whole, as are the relationships between humans and the society, and between the internal organs of the human body, so it values the impacts of natural and social environment on health and illness. Moreover, it believes that the mind and body are closely connected, emphasizing the coordination of physical and mental factors and their interactions in the conditions of health and illness.

Second, setting great store by the principle of harmony. TCM lays particular stress on the importance of harmony on health, holding that a person’s physical health depends on harmony in the functions of the various body organs, the moderate status of the emotional expression, and adaption and compliance to different environments, of which the most vital is the dynamic balance between yin and yang. The fundamental reason for illness is that various internal and external factors disturb the dynamic balance. Therefore, maintaining health actually means conserving the dynamic balance of body functions, and curing diseases means restoring chaotic body functions to a state of coordination and harmony.

Third, emphasis on individuality. TCM treats a disease based on full consideration of the individual constitution, climatic and seasonal conditions, and environment. This is embodied in the term “giving treatment on the basis of syndrome differentiation.” Syndrome differentiation means diagnosing an illness as a certain syndrome on the basis of analyzing the specific symptoms and physical signs collected by way of inspection, auscultation & olfaction, inquiry, and palpation, while giving treatment means defining the treatment approach in line with the syndrome differentiated. TCM therapies focus on the person who is sick rather than the illness that the patient contracts, i.e., aiming to restore the harmonious state of body functions that is disrupted by pathogenic factors.

Fourth, emphasis on preventative treatment. Preventative treatment is a core belief of TCM, which lays great emphasis on prevention before a disease arises, guarding against pathological changes when falling sick, and protecting recovering patients from relapse. TCM believes that lifestyle is closely related to health, so it advocates health should be preserved in daily life. TCM thinks that a person’s health can be improved through emotional adjustment, balanced labor and rest, a sensible diet, and a regular life, or through appropriate intervention in the lifestyle based on people’s specific physical conditions. By these means, people can cultivate vital energy to protect themselves from harm and keep healthy.

Fifth, simplicity. TCM doctors diagnose patients through inspection, auscultation & olfaction, inquiry, and palpation. In addition to medication, TCM has many non-pharmacological alternative approaches such as acupuncture and moxibustion, tuina (massage), cupping and guasha (spooning). There is no need for complex equipment. TCM tools, for example, the small splints used in Chinese osteopathy, the spoons used in guasha, or the cups used in cupping therapy, can draw from materials close at hand, so that such treatments can spread easily.

3. TCM’s Contributions

TCM is an important component and a characteristic feature of traditional Chinese culture. Applying such principles as “man should observe the law of the nature and seek for the unity of the heaven and humanity,” “yin and yang should be balanced to obtain the golden mean,” and “practice of medicine should aim to help people,” TCM embodies the core value of Chinese civilization. TCM also advocates “full consideration of the environment, individual constitution, and climatic and seasonal conditions when practicing syndrome differentiation and determining therapies,” “reinforcing the fundamental and cultivating the vital energy, and strengthening tendons and bones,” and “mastership of medicine lying in proficient medical skills and lofty medical ethics,” all concepts that enrich Chinese culture and provide an enlightened base from which to study and transform the world.

TCM originated in the Chinese culture. It explains health and diseases from a macro, systemic and holistic perspective. It shows how China perceives nature. As a unique form of medicine, TCM exercises a profound influence on the life of the Chinese people. It is a major means to help the Chinese people maintain health, cure diseases, and live a long life. The Chinese nation has survived countless natural disasters, wars and pestilences, and continues to prosper. In this process, TCM has made a great contribution.

Born in China, TCM has also absorbed the essence of other civilizations, evolved, and gradually spread throughout the world. As early as the Qin and Han dynasties (221 BC-AD 220), TCM was popular in many neighboring countries and exerted a major impact on their traditional medicines. The TCM smallpox vaccination technique had already spread outside of China during the Ming and Qing dynasties (1368-1911). The Ben Cao Gang Mu (Compendium of Materia Medica) was translated into various languages and widely read, and Charles Darwin, the British biologist, hailed the book as an “ancient Chinese encyclopedia.” The remarkable effects of acupuncture and moxibustion have won it popularity throughout the world. The discovery of qinghaosu (artemisinin, an anti-malaria drug) has saved millions of lives, especially in developing countries. Meanwhile, massive imports of medicinal substances such as frankincense and myrrh have enriched TCM therapies.

II. Policies and Measures on TCM Development

China lays great store by the development of TCM. When the People’s Republic was founded in 1949, the government placed emphasis on uniting Chinese and Western medicine as one of its three guidelines for health work, and enshrined the important role of TCM. In 1978, the Communist Party of China (CPC) Central Committee transmitted throughout the country the Ministry of Health’s “Report on Implementing the Party’s Policies Regarding TCM and Cultivating TCM Practitioners,” and lent great support in areas of human resources, finance, and supplies, vigorously promoting the development of TCM. It is stipulated in the Constitution of the PRC that the state promotes modern medicine and traditional Chinese medicine to protect the people’s health. In 1986, the State Council set up a relatively independent administration of TCM. All provinces, autonomous regions, and municipalities directly under the central government have established their respective TCM administrations, which has laid an organizational basis for TCM development. At the Fourth Meeting of the Seventh National People’s Congress, equal emphasis was put on Chinese and Western medicine, which was made one of the five guidelines in China’s health work in the new period. In 2003 and 2009, the State Council issued the “Regulations of the People’s Republic of China on Traditional Chinese Medicine” and the “Opinions on Supporting and Promoting the Development of Traditional Chinese Medicine,” gradually forming a relatively complete policy system on TCM.

Since the CPC’s 18th National Congress in 2012, the Party and the government have granted greater importance to the development of TCM, and made a series of major policy decisions and adopted a number of plans in this regard. At the National Conference on Hygiene and Health held in August 2016, President Xi Jinping emphasized the importance of revitalizing and developing traditional Chinese medicine. The CPC’s 18th National Congress and the Fifth Plenary Session of the 18th CPC Central Committee both reiterated the necessity to pay equal attention to the development of traditional Chinese medicine and Western medicine and lend support to the development of TCM and ethnic minority medicine. In 2015, the executive meeting of the State Council approved the Law on Traditional Chinese Medicine (draft) and submitted it to the Standing Committee of the National People’s Congress for deliberation and approval, intending to provide a sounder policy environment and legal basis for TCM development. In 2016 the CPC Central Committee and the State Council issued the Outline of the Healthy China 2030 Plan, a guide to improving the health of the Chinese people in the coming 15 years. It sets out a series of tasks and measures to implement the program and develop TCM. The State Council issued the Outline of the Strategic Plan on the Development of Traditional Chinese Medicine (2016-2030), which made TCM development a national strategy, with systemic plans for TCM development in the new era. These decisions and plans have mapped out a grand blueprint that focuses on the full revitalization of TCM, accelerated reform of the medical and healthcare system, the building of a medical and healthcare system with Chinese characteristics, and the advancement of the healthy China plan, thus ushering in a new era of development for TCM.

The basic principles and main measures envisioned to develop TCM are:

Putting people first, and making achievements in TCM development accessible to everyone. TCM roots deep among the public, and the philosophies it contains are easy to understand. To meet the people’s demand for healthcare, China endeavors to expand the supply of TCM services, improve community-level TCM health management, advance the integral development of TCM with community service, care of the elderly and tourism, spread knowledge of TCM and advocate healthy ways of life and work, enhance welfare for the public, and ensure that the people can enjoy safe, efficient, and convenient TCM services.

Equal attention to TCM and Western medicine. Equal status shall be accorded to TCM and Western medicine in terms of ideological understanding, legal status, academic development, and practical application. Efforts shall be made to improve system of administration related to TCM, increase financial input, formulate policies, laws and regulations suited to the unique features of TCM, promote coordinated development of TCM and Western medicine, and make sure that they both serve the maintenance and improvement of the people’s health.

Making TCM and Western medicine complementary to each other, and letting each play to its strengths. The state encourages exchanges between TCM and Western medicine, and creates opportunities for Western medical practitioners to learn from their TCM counterparts. Modern medicine courses are offered at TCM colleges and universities to strengthen the cultivation of doctors who have a good knowledge of both TCM and Western medicine. In addition to the general departments, TCM hospitals have been encouraged to open specialized departments for specific diseases. General hospitals and community-level medical care organizations have been encouraged to set up TCM departments, and TCM has been made available to patients in the basic medical care system and efforts have been made to make it play a more important role in basic medical care. A mechanism has been established for TCM to participate in medical relief of public emergencies and the prevention and control of serious infectious diseases.

Upholding the dialectical unity of tradition and innovation, i.e., maintaining TCM’s characteristics while actively applying modern science and technology in TCM development. A system has been established to carry forward the theories and clinical experience of well-known veteran TCM experts, and efforts have been made to rediscover and categorize ancient TCM classics and folk medical experience and practices. A system of technological innovation has been established to advance TCM progress, and efforts have been made to carry out systemic research on the fundamental theories, clinical diagnosis and treatment, and therapeutic evaluation of TCM. Interdisciplinary efforts have been organized in joint research on the treatment and control of major difficult and complicated diseases and major infectious diseases, as well as research on the prevention and treatment of common diseases, frequently occurring diseases, and chronic diseases using TCM. Endeavor has been made in the R&D of new TCM medicines, and medical devices and equipment.

Making overall plans for integrated, coordinated and sustainable development of TCM. The state makes overall plans for the coordinated development of TCM, integrating such areas as TCM clinical practices, healthcare, R&D, education, industry, and culture. Efforts have been made to improve community-level TCM services and the TCM medical care system. A health promotion project featuring preventative treatment of diseases has been launched to enhance TCM medical care. China has built research bases for TCM clinical studies, developed a system of coordination and innovation for the prevention and treatment of major diseases with TCM, and launched programs for training professionals necessary for TCM inheritance and innovation, and improving the quality of the ranks of TCM workers. The state has set out to promote the green development of the entire TCM industrial chain, and vigorous efforts have been made in the development of non-pharmacological therapies. Further efforts have been made to upgrade the TCM industry and develop it into an emerging strategic industry. A nationwide program has been conducted to promote the core values of TCM.
Promoting TCM development by way of government support and multi-party participation. The government has made TCM an important component of economic and social development, and has included it in relevant plans and provided financial support. The state has strengthened the supervision and administration of TCM practices, and initiated a market access system for TCM practitioners, TCM medical institutions, and TCM medicines, and improved the standards for the quality and safety of TCM service. The government has developed preferential policies to let the market play a full and decisive role in allocating resources, and is striving to create a market environment characterized by equal participation and fair play, so as to maximize the potential and vitality of TCM. Encouragement has been given to social capital to support the development of TCM, and to private investors to establish TCM healthcare institutions.

III. Carrying Forward the Tradition and Ensuring the Development of TCM

Establishment of a TCM medical care system covering both urban and rural areas. An urban TCM medical care network, mainly comprising hospitals for TCM (including ethnic minority medicine and integrated Chinese and Western medicine), TCM clinics and general hospitals’ TCM clinical departments, and community health centers, has been formed. A rural TCM medical care network has been established, mainly composed of county-level TCM hospitals, TCM clinical departments of general hospitals (specialized hospitals and maternal & child health centers), TCM departments of township-level health centers, and village health clinics, which provides basic TCM healthcare services.

Statistics collected at the end of 2015 show that there were 3,966 TCM hospitals across the country, including 253 hospitals of ethnic minority medicine and 446 hospitals of integrated Chinese and Western medicine; there were 452,000 practitioners and assistant practitioners of TCM (including practitioners of ethnic minority medicine and integrated Chinese and Western medicine); there were 42,528 TCM clinics, including 550 for ethnic minority medicine and 7,706 for integrated medicine; there were 910 million visits that year to TCM medical and health service units across the country and 26,915,000 inpatients treated.

In addition to making contribution to the prevention and treatment of common, endemic and difficult diseases, TCM has played an important role in the prevention and treatment of major epidemics and medical relief in public emergencies and natural disasters. The contribution of TCM and integrated Chinese and Western medicine in treating SARS (severe acute respiratory syndrome) has been affirmed by the World Health Organization (WHO). TCM treatment of influenza A virus subtype H1N1 has yielded satisfactory results, arousing widespread attention in the international community. In addition, TCM has made distinctive contributions to the prevention and control of epidemics such as HIV/AIDS (Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome), HFMD (Hand, Foot and Mouth Disease), and Influenza A virus subtype H7N9 in humans, as well as to medical relief following the Wenchuan earthquake, the Zhouqu mudslide and other public emergencies and natural disasters.
Expedited development of TCM disease prevention and healthcare services. The system of TCM disease prevention and healthcare services has been expedited by establishing preventative healthcare departments at TCM hospitals at/above the second class and providing TCM preventative medical care services at community-level medical and health service institutions, maternal & child health centers and rehabilitation centers. Also seen is rapid growth in the number of privately run TCM healthcare institutions. Endeavor has been made to promote the development of TCM health services and carry out TCM health tourism and TCM integrated treatment and convalesce. TCM health management program has been incorporated as a separate category into the national basic public health service program, gradually releasing the potential and strengths of TCM in public health services, thus fostering a shift from treatment of serious diseases to comprehensive health management in the mode of health development.

Important role played by TCM in the reform of the medical care system. In the course of advancing the reform, TCM’s distinct strengths, such as its clinical effectiveness, its unique role, flexible ways of treatment and relatively low cost in disease prevention and healthcare, have been fully exploited to augment benefits of reform for the people and enriched the connotation of China’s basic medical care system with distinct characteristics. With relatively low cost, TCM has contributed rather a higher share of services in relation to the resources it is entitled to. The medical care services provided by TCM institutions in the national total increased from 14.3 percent to 15.7 percent in the few years from 2009 to 2015. In 2015, out-patient expenses per visit and in-patient expenses per capita at public TCM hospitals were, respectively, 11.5 percent and 24 percent lower than those at general public hospitals.

Building a distinctive system of training for TCM professionals. Training of professionals is essential for the development of TCM. Thus, great efforts have been made to promote development of education in TCM, basically putting in place a system of training for TCM professionals that features an organic link-up between college, graduate and continuing education, and run through master-apprenticeship training. This, together with a mechanism for training of practical TCM professionals geared toward the needs of the urban and rural communities that has also been initially established, forms a multi-dimensional education network covering multiple disciplines at different levels, including TCM, traditional Chinese pharmacology, integrated Chinese and Western medicine, and ethnic minority medicine at secondary and higher vocational schools, colleges, postgraduate and doctoral studies. By the end of 2015, there were throughout the country 42 institutions of higher learning in TCM (including 25 TCM colleges), and more than 200 Western medicine institutions of higher learning or non-medical higher learning institutions offering programs in TCM, enrolling in total as many as 752,000 students.

In the course of implementing the program of training professionals for inheritance and innovation in TCM, efforts have been made to conserve and disseminate the academic ideas and practical experience of the fifth batch of prominent TCM experts. By 2015, 1,016 studios had been set up for carrying forward their expertise; 200 studios had been set up for passing on the expertise of prominent TCM experts at the grassroots level; 64 studios had been established for promoting various schools of TCM.

TCM training programs targeted at professionals at both grassroots and higher levels have been held, such as training in TCM knowledge and skills for village doctors, training for conserving special traditional pharmacological skills, and advanced training for outstanding TCM clinical practitioners. Together, 124 researchers are finishing postdoctoral studies in TCM inheritance at the Chinese Academy of Chinese Medical Sciences and their work is being evaluated. Exploration has been made in establishing an incentive mechanism for outstanding TCM workers to come to the fore. By 2015, the title of TCM Master had been awarded to a total of 60 experts practicing TCM and ethnic minority medicine.

Positive progress made in TCM scientific research. Sixteen national TCM clinical research bases have been built as part of the clinical research system for preventing and treating infectious diseases and chronic non-infectious diseases with TCM. This, together with a number of key research centers and labs covering all disciplines of TCM and national engineering (technology) research centers and labs in this respect, have brought into being a TCM sci-tech innovation system that is based on independent TCM research institutes, TCM universities, and TCM hospitals at and above the provincial level, and participated by comprehensive universities, general hospitals and TCM enterprises.

In recent years, 45 TCM research achievements have been awarded national sci-tech prizes, of which five were first-prize winners of the National Science and Technology Progress Award. Tu Youyou won the 2011 Lasker Award in clinical medicine and the 2015 Nobel Prize in Physiology or Medicine for discovering qinghaosu (artemisinin). Wang Zhenyi and Chen Zhu were awarded the Seventh Annual Szent-Gyorgyi Prize for Progress in Cancer Research for combining the Western medicine ATRA and the TCM compound arsenic trioxide to treat acute promyelocytic leukemia (APL).

A pilot program for Chinese medicinal resources survey has been implemented, forming a dynamic information and technology system with one central platform, 28 provincial-level centers, and 65 monitoring stations. Sixteen seed and seedling bases for Chinese medicinal plants and two germplasm banks have been established. Organizational work has been done for collation of literature and screening of appropriate skills of ethnic minority medicine, involving 150 works on ethnic minority medicine and 140 appropriate skills. The transformation and application of these research results has provided support for enhancing clinical effectiveness, ensuring the quality of Chinese medicine, and fostering the sound development of the TCM pharmaceutical industry.

Rapid development of the TCM pharmaceutical industry. A number of laws and regulations have been enacted and implemented on strengthening the protection of TCM wild medicinal resources; a number of national and local nature reserves have been established; research has been conducted on the protection of rare and endangered Chinese medicinal resources; and artificial production or wild tending have been carried out for certain scarce and endangered resources.

A registration management system has been basically established for TCM pharmaceuticals under the guidance of theories of traditional Chinese medicine and pharmacology, highlighting the strengths of TCM, setting great store by clinical practice and encouraging innovation. To date, 60,000 TCM and ethnic minority medical drugs have been approved, and 2,088 pharmaceutical enterprises that have been approved by the Good Manufacturing Practice (GMP) of Medical Products are manufacturing Chinese patent medicines. The dosage forms of TCM medicines have increased from a traditionally limited number of forms such as pills, powders, ointments and pellets into more than 40, including dropping pills, tablets, pods and capsules, indicating marked improvement in the technological level of Chinese medicinal drug production, and initial establishment of a modern Chinese medicine industry based on the production of medicinal materials and industrial production and tied together by commerce.

In 2015, the total output value of the TCM pharmaceutical industry was RMB786.6 billion, accounting for 28.55 percent of the total generated by the country’s pharmaceutical industry, and becoming a new source of growth in China’s economy. Planting Chinese medicinal herbs has become a key means of adjusting the rural industrial structure, improving the eco-environment, and increasing farmers’ incomes. Trade in Chinese medicinal products has maintained rapid growth, and the export value of Chinese medicines amounted to US$3.72 billion in 2015, signifying the great potential of Chinese medicines in overseas markets. The TCM pharmaceutical industry has gradually developed into an industry with distinctive strengths and broad market prospects, which is of strategic importance to national economic and social development.

New progress in TCM culture. The Chinese government treasures and protects the cultural value of TCM, and endeavors to build a system for passing on the traditional culture of TCM. In total, 130 TCM elements have been incorporated into the Representative List of National Intangible Cultural Heritage, with TCM acupuncture and moxibustion being included in the Representative List of the Intangible Cultural Heritage of Humanity by UNESCO, and the Huang Di Nei Jing (Yellow Emperor’s Inner Canon) and Ben Cao Gang Mu (Compendium of Materia Medica) are listed in the Memory of the World Register. Efforts have been reinforced to promote public awareness in TCM healthcare, including events under the campaign of Traditional Chinese Medicine Across China. Public talks have been organized through media and TCM education bases popularizing basic knowledge and skills of TCM healthcare and prevention and treatment of illnesses. In this way, public awareness of and ability to practice TCM healthcare has been enhanced, and general public health has improved.

Positive progress in TCM standardization. The Outline of the Medium- and Long-term Development Plan for the Standardization of Traditional Chinese Medicine (2011-2020) has been issued and implemented, putting in place initially a system of TCM standards which amount to 649, showing an average annual growth of 29 percent. Five national technical committees of standardization have been established for, respectively, Chinese medicine, acupuncture and moxibustion, TCM drugs, integrated Chinese and Western medicine, and seeds and seedlings of Chinese medicinal plants, with local standardization technical committees of traditional Chinese medicine and pharmaceuticals being set up in Guangdong, Shanghai, Gansu and some other localities. The building of 42 research and application bases for TCM standardization is proceeding smoothly, and the clinical application of guidelines for TCM diagnosis and treatment of commonly seen diseases and guidelines for acupuncture and moxibustion is proving effective.

Steady progress has also been witnessed in standardization of ethnic minority medicine, so has been orderly advancement in the formulation of guidelines for diagnosis and treatment of commonly seen diseases. In this regard, Uyghur medicine has taken the lead, with the publishing of 14 guidelines for disease diagnosis and treatment, and curative effect evaluation. The first local technical committee for standardization of Tibetan medicine has been established in the Tibet Autonomous Region. Constant improvement has been observed in the competence and efficiency of institutions and workers in relation to the standardization of ethnic minority medicine and pharmacology.

IV. International Exchanges and Cooperation in TCM

Promoting the globalization of TCM. Traditional Chinese medicine has been spread to 183 countries and regions around the world. According to the World Health Organization, 103 member states have given approval to the practice of acupuncture and moxibustion, 29 have enacted special statutes on traditional medicine, and 18 have included acupuncture and moxibustion treatment in their medical insurance provisions. TCM medicines have gradually entered the international system of medicines, and some of them have been registered in Russia, Cuba, Vietnam, Singapore, United Arab Emirates, and other nations. Some 30 countries and regions have opened a couple of hundred TCM schools to train native TCM workers. The World Federation of Acupuncture-Moxibustion Societies, headquartered in China, has 194 member organizations from 53 countries and regions, and the World Federation of Chinese Medicine Societies has 251 member organizations from 67 countries and regions. Traditional Chinese medicine has become an important area of health and trade cooperation between China and the ASEAN, EU, Africa, and Central and Eastern Europe, a key component in people-to-people exchanges between China and the rest of the world and between Eastern and Western cultures, and an important vehicle for China and other countries to work together in promoting world peace, improving the well-being of humanity, and developing a community of shared future.

Supporting the global development of traditional medicine. The Chinese government is dedicated to promoting the development of traditional medicine throughout the world, and works closely with the WHO to contribute to progress in traditional medicine around the globe. China has summarized its successful TCM practices and offers them to the world. It hosted the first WHO Congress on Traditional Medicine in Beijing in 2008, and played an important role in drafting the Beijing Declaration. In accordance with initiatives of the Chinese government, the 62nd and 67th World Health Assemblies passed two resolutions on traditional medicine, and urged its member states to implement the WHO’s Traditional Medicine Strategy 2014-2023. Currently, the Chinese government has signed 86 TCM cooperation agreements with other countries and international organizations, and has supported the building of 10 TCM centers overseas.

Promoting standard management of TCM internationally. To promote the orderly development of TCM around the globe and ensure its safe, efficient and targeted application, China has facilitated the founding of the ISO/TC249 Traditional Chinese Medicine in the ISO. With its secretariat in Shanghai, it has now issued a series of ISO standards on TCM. Thanks to China’s efforts, the WHO has included traditional medicine, represented by TCM, in the new version of the International Classification of Diseases (ICD-11). China is working actively to promote international exchange and cooperation in the supervision and management of traditional medicine, in an effort to ensure that it is safe and effective.

Providing TCM medical aid overseas. While seeking its own development, within its capacity China has persisted in providing aid and assistance to other developing countries, fulfilling its due international obligations. To date, China has sent medical teams to over 70 countries in Asia, Africa, and Latin America, with TCM professionals in almost every team, accounting for 10 percent of the total number of staff. A project has been launched to build TCM centers in African countries, and specialized TCM stations have opened in Kuwait, Algeria, Tunisia, Morocco, Malta, and Namibia. The Chinese government has sponsored 10 TCM centers overseas. In recent years, China has strengthened work in the prevention and control of AIDS and malaria in developing countries, and in African countries in particular, sending a total of 400 TCM specialists to more than 40 countries including Tanzania, Comoros, and Indonesia. Chinese medical teams have treated complicated and refractory diseases with TCM, acupuncture and moxibustion, medical massage, and methods combining Chinese and Western medicine, saving many lives and winning extensive appreciation from governments and people concerned.

Conclusion

China’s economic development has entered a new historical period. TCM has come to play an increasingly significant role in the socio-economic development; it has become a unique resource in terms of healthcare, an economic resource with great potential, a scientific and technological resource with originality advantages, an outstanding cultural resource, and an ecological resource of great importance. The time has come for TCM to experience a renaissance.

China will learn from the achievements of modern civilization, uphold the principle of making the ancient serve the contemporary, and strive to promote the modernization of TCM by making every effort to carry on the good traditions and practices of Chinese medicine, and promote the innovative development of TCM for health preservation, so that TCM will be incorporated into the modern outlook on health to serve the people. By 2020, every Chinese citizen will have access to basic TCM services, and by 2030 TCM services will cover all areas of medical care. Meanwhile, China will also actively introduce TCM to the rest of the world, and promote the integration of TCM and other traditional medicine with modern technology, so as to explore a new model of healthcare to improve the well-being of all people of the world, and make a full contribution to global progress and a brighter future for mankind.

Spearheaded by NCCAOM®, the New Designation Means Greater Recognition Across Federal Agencies and Access to Programming

Jacksonville, FL — The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM?) today announced it has successfully secured an independent Standard Occupational Code (SOC) for Acupuncturists from the U.S. Bureau of Labor Statistics (BLS). The new code for Acupuncturists – SOC – 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.

“Earning a distinct Standard Occupational Code for Acupuncturists is a milestone moment for the acupuncture and Oriental medicine profession. This event positions acupuncturists for a number of new opportunities,” said Kory Ward-Cook, Ph.D., CAE, chief executive officer of NCCAOM. “The classification of ‘Acupuncturists’ as its own federally-recognized labor category both validates and bolsters the profession and positions the industry for growth.”

The newly confirmed designation is the result of a decade-long initiative, spearheaded by NCCAOM in collaboration with a number of national, professional organizations, spanning two separate submissions requesting an independent occupational code for Acupuncturists. It was at an acupuncture and Oriental medicine national leaders meeting in 2006, that it was discovered that acupuncture was included as a modality under chiropractors and nurses, in the BLS Occupational Handbook.

In order to earn a unique SOC, the BLS requires professions to be trackable and growing.  Since BLS data is shared across federal agencies, acupuncturists’ recognition through an independent SOC means it will appear as a specific job classification with U.S. Department of Labor, National Center for Education Statistics, U.S. Department of Defense, National Science Foundation, and U.S. Census Bureau.

NCCAOM, backed by the support of the American Association of Acupuncture and Oriental Medicine (AAAOM), the Accreditation Commission for Acupuncture and Oriental Medicine

(ACAOM), the Council of Colleges for Acupuncture and Oriental Medicine (CCAOM), Federation Acupuncture and Oriental Medicine Regulatory Agencies (FAOMRA), and the National Acupuncture Foundation (NAF), made its first filing with SOC Policy Committee (SOCPC) in 2008. This first submission resulted in Acupuncturists being tracked by O-Net, and subsequently assigned to a major SOC category 29-1000 – Other diagnosing and treating health professions.

David W. Miller, MD., Dipl. O.M. (NCCAOM)?, LAc.,  chair of the 2014 BLS Proposal Submission Subcommittee of NCCAOM’s Research Committee and current chair of the newly formed American Society of Acupuncturists (ASA), was instrumental in culling, organizing, and formatting data from various sources, but most significantly from the NCCAOM’s 2013 Job Analysis Survey. This data demonstrated that the number of practitioners exclusively providing acupuncture and Asian medicine was growing and that it was a unique profession. “The process of developing the second proposal called upon a collaborative effort of many industry experts to validate the profession through real data,” said Miller. “Securing the distinct Standard Occupational Code (SOC) was a necessary and hugely influential step in continuing the development and growth of the discipline of acupuncture and East Asian medicine.”

Source: ACUPUNCTURISTS EARN UNIQUE OCCUPATIONAL CODE FROM U.S. BUREAU OF LABOR STATISTICS

The Bureau of Labor Statistics (BLS) has just published its proposed 2018 BLS Standard Occupational Classification (SOC) changes. BLS announcement of the publication of the July 22, 2016 federal register showed Acupuncturists now have an independent SOC! It is Code #29-1291.

The report explained “Multiple dockets requested a new detailed occupation for Acupuncturists, which are classified in 29-1199 Health Diagnosing and Treating Practitioners in the 2010 SOC. The SOCPC accepted this recommendation because the work performed by Acupuncturists is sufficiently distinct to reliably collect data, as required by Classification Principle 9. The SOCPC recommends establishing a new code for this occupation, 29-1291 Acupuncturists.”（ http://www.bls.gov/soc/2018/soc_responses.htm(link is external)）

“This is a monumental step forward for the profession.” Said by Kory Ward-Cook, Ph.D., CAE, the Chief Executive Officer of NCCAOM, who has contributed for this special over years.