Functional Model of Healthcare (rev 2)

[Guest guest]

I'm going to try to elaborate now on some concepts of the Functional Model of

Healthcare, and how this relates to the improperly phrased question of

whether we should be focusing on Chinese medicine or western medicine.

 

I personally don't know, at this point, exactly how much of internal (or let's

just

call it everything other than physical med) can be analyzed / evaluated with

this strategy, but I can tell you that it is almost certainly a better strategy

than

relying on microscopic chemistry, because that clearly feeds into the biomed

high-tech model. (Yes, I'm sure there will be an odd experimental nano/stem

researcher or two (out of millions) who want the sage wisdom input of a

classical acupuncture/herbalist to balance what they do with a touch of

nature).

 

Two things should be reminded; 1) - that some of the so-called

musculoskeletal pain cases that wind up being lumped in with " all those 4-

patient-an hour orthopods who treat pain (sneer) and not the pattern like the

best traditionalists " , - are actually internal med cases. I believe numbers for

this are far under-acknowledged (and that's with a background of doing many

evals as an employee for a Comp / PI physician group). (by the way, typically

1 to 2 hours, plus a day or more of review and writing time for a

comprehensive eval, which no one does anymore since about 12 years).

And 2) – anybody who learned the insurance game figured out that

regardless of what actually runs through your head about causation, pattern

and process, or what you think might be possible action of multi-faceted

therapeutics, what you are evaluating and possibly treating for the record - is

what is reasonable, acceptable and justifiable. Which also happens to be

what government regulation mandates. One way to interpret this potential

scenario is that you evaluate and document what is acceptable and paid for.

If I tell you any more I'll have to kill you, or at least collect my usual

fee;-)

 

Importantly, when you really grasp this, there is nothing about it that is

lacking

in integrity. An analogy comes to mind, of a friend who few years ago wanted

to start a web site for his portrait painting business. Since then, he became

an

orthodox cleric, and it was that mindset that caused a reflex shudder when I

suggested that, rather than pay several hundred or more for a site designer,

he should do what everybody else does – namely " show source and steal a

site. " Now, you and I know that, as a vernacular expression that really means

to observe appearance and measurements, study details, and emulate and

adapt a template, which is how most learning happens, but obviously I chose

the wrong words, and nothing was going to get past the barrier that had just

gone up.

 

Continually twisting this into an educational institute issue of how much basic

science should be part of acupuncture school completely misses the reality.

Clinical assessment and functional analysis by current-day international

standards requires plenty of logic, algorithm, knowledge and skill. Yet,

although it doesn't hurt to be able to derive pointers from research arcana, -

knowing and focusing on microbiology etc. not only tends to miss some of the

broader holistic (sometimes simplistic, yet useful) perspective, it is mostly

unnecessary because functional status has less to do with deviation from

norm, than how the person is adapting. Any particular detail, when compared

to a so-called norm, is actually meaningless, unless it can be shown to be a

factor in effecting an impairment in the person's life, and generally the

baseline is what the person could do before, that they can't do now. Which

brings up far greater applicability for this approach than the " musculoskeletal "

practice that some insist (with great inaccuracy) on pigeonholing me into .

 

I have more ideas about this and will collaborate given the right incentive, but

the pressing issue right now, and the reason for my outreach, is not that I care

to debate one or two people, but in recognition of the real need to avert a

potentially impending train wreck, brought on in part by ongoing clever or

misguided spin. It's not like I and others who understand the situation like I

do

asked for laws to force a style of practice on (you). There are a number of

antagonist forces coming together from outside the profession due to the

larger problems in healthcare, but there is also no small amount of prejudice

bias within - against people who've had the mind, background and initiative to

stretch boundaries – both to other aspects of holistic/oriental medicine that

are not asian such as Nogier's later work (not to mention that his earlier work

wasn't asian either) or Travell, and as well, to attempt to serve the 95% of the

population that is not going to pay any worthwhile amount of cash per visit

(thanks to the cunning of insurance and pseudo-insurance co-pay).

Additionally, an attitude that I know is indoctrinated across the board in the

schools is that what should be aimed for is to merely excel in simple classical

style – and a smug disdain for insurance and laws and personal injury and

(all us negative people who want to bring you down). Don't imagine that

people who are continuing to strive to integrate with the rest of the healthcare

system don't know how to do a cash practice. I was a successful MT in

SantaFe of all places, and I walked around with a shaving-kit bag of western

herbs for years before then. If I get forced back to cash-only 23 years later

because of mass foolishness, the AC license is going out the window, and

everyone else will be advised to do the same, because competent

underground practitioners (who even know these issues of defensibility that

I'm talking about) can be trained for a whole lot less than the 10 – 40

thousand that accredited schools are getting ! Everyone concurred that the

bar was going to be raised in education, and most people one year out

understand why. It's no mystery why a 3- state institution like Pacific doesn't

want minimum standards set out of line with competing schools in other

states.

 

I'm trying to show you all that the knowledge that is missing from the picture

is

a lot more practical than either pre-med type science on the one hand, or

training to attempt speculative interpretation of ancient literature on the

other.

Really, I would prefer NO changes to the current law rather the current crop as

it looks.

 

Joe Reid, LAc, OMD 2005 Reproduction only with prior

permission http://www.jreidomd.blogspot.com