A case in point

[Guest guest]

Right on this very discussion board, in the middle of this dialogue

about ABORM, and who is or is not qualified to treat infertility

somebody posted a very simple question, " What is PCOS? "

 

See message #26271.

 

I presume that the person who posted the question is an acupuncturist,

as most of us on this discussion board are. So I ask you this, is this

acupuncturist qualified to treat and manage infertility cases??

 

Those of you who argue against specialty certification and claim that

all acupuncturists are created equal, do you honestly feel that

someone who does not know what PCOS is should be treating infertility??

 

There is absolutely nothing wrong with not knowing that. None of us

knows everything about every syndrome. But this is precisely why

specialization and Board Certification in specialized areas is needed

and is valuable.

 

David Karchmer

[Guest guest]

Correction: It was message #26267

 

Right on this very discussion board, in the middle of this dialogue

> about ABORM, and who is or is not qualified to treat infertility

> somebody posted a very simple question, " What is PCOS? "

>

> See message #26271.

>

> I presume that the person who posted the question is an

acupuncturist,

> as most of us on this discussion board are. So I ask you this, is

this

> acupuncturist qualified to treat and manage infertility cases??

>

> Those of you who argue against specialty certification and claim

that

> all acupuncturists are created equal, do you honestly feel that

> someone who does not know what PCOS is should be treating

infertility??

>

> There is absolutely nothing wrong with not knowing that. None of

us

> knows everything about every syndrome. But this is precisely why

> specialization and Board Certification in specialized areas is

needed

> and is valuable.

>

> David Karchmer

>

[Guest guest]

David,

 

To clarify, I posted the question, and yes, I am a licensed acupuncturist. It

is true, I had not previously seen the acronym " PCOS " for polycystic ovarian

syndrome. Nor have I ever treated anyone who had been diagnosed with this

condition. I do know of the diagnosis, but had not heard the acronym before.

While I have successfully treated women for a wide variety of gynecological

issues, I do not do fertility medicine. My expertise lies in other areas.

 

, MSTOM, LAc, Dipl OM (NCCAOM)

 

David Karchmer <acuprof wrote: Right on this very discussion board,

in the middle of this dialogue

about ABORM, and who is or is not qualified to treat infertility

somebody posted a very simple question, " What is PCOS? "

 

See message #26271.

 

I presume that the person who posted the question is an acupuncturist,

as most of us on this discussion board are. So I ask you this, is this

acupuncturist qualified to treat and manage infertility cases??

 

Those of you who argue against specialty certification and claim that

all acupuncturists are created equal, do you honestly feel that

someone who does not know what PCOS is should be treating infertility??

 

There is absolutely nothing wrong with not knowing that. None of us

knows everything about every syndrome. But this is precisely why

specialization and Board Certification in specialized areas is needed

and is valuable.

 

David Karchmer

 

 

 

Subscribe to the fee online journal for TCM at Times

http://www.chinesemedicinetimes.com

 

Help build the world's largest online encyclopedia for Chinese medicine and

acupuncture, click, http://www.chinesemedicinetimes.com/wiki/CMTpedia

 

 

and adjust

accordingly.

 

 

 

Please consider the environment and only print this message if absolutely

necessary.

 

[Guest guest]

Andrea,

 

Thanks for clarifying. Please understand that I mean no disrespec,

and I certainly do not doubt your abilities as an acupuncturist. But

I use your comments as an illustration to those who argue that every

acupuncturist is equally qualified to treat and manage Infertility

cases. EVERY acupuncturist who treats infertility regularly knows

that acronym.

 

Again, please pardon me if I singled you out or if my comment was

crass. I beleive that it furthers the point that I am trying to make

that there exists a genuine and immediate need to give both doctors

and the general public a means by which they can assess who

possesses the specialized knowledge and expertise required to

effectively treat infertility with hacupuncture and TCM.

 

David Karchmer

 

Chinese Medicine , Andrea Beth

Damsky < wrote:

>

> David,

>

> To clarify, I posted the question, and yes, I am a licensed

acupuncturist. It is true, I had not previously seen the

acronym " PCOS " for polycystic ovarian syndrome. Nor have I ever

treated anyone who had been diagnosed with this condition. I do

know of the diagnosis, but had not heard the acronym before. While

I have successfully treated women for a wide variety of

gynecological issues, I do not do fertility medicine. My expertise

lies in other areas.

>

> , MSTOM, LAc, Dipl OM (NCCAOM)

>

> David Karchmer <acuprof wrote: Right on this very discussion

board, in the middle of this dialogue

> about ABORM, and who is or is not qualified to treat infertility

> somebody posted a very simple question, " What is PCOS? "

>

> See message #26271.

>

> I presume that the person who posted the question is an

acupuncturist,

> as most of us on this discussion board are. So I ask you this, is

this

> acupuncturist qualified to treat and manage infertility cases??

>

> Those of you who argue against specialty certification and claim

that

> all acupuncturists are created equal, do you honestly feel that

> someone who does not know what PCOS is should be treating

infertility??

>

> There is absolutely nothing wrong with not knowing that. None of

us

> knows everything about every syndrome. But this is precisely why

> specialization and Board Certification in specialized areas is

needed

> and is valuable.

>

> David Karchmer

>

>

>

> Subscribe to the fee online journal for TCM at

Times http://www.chinesemedicinetimes.com

>

> Help build the world's largest online encyclopedia for Chinese

medicine and acupuncture, click,

http://www.chinesemedicinetimes.com/wiki/CMTpedia

>

>

and

adjust accordingly.

>

> Messages are the property of the author. Any duplication outside

the group requires prior permission from the author.

>

> Please consider the environment and only print this message if

absolutely necessary.

>

[Guest guest]

Dear David,

 

I am sure I did not know the acronym PCOS. Does this mean that

any acupuncturist should recognize this ? Am I also out of the game?

I thought TCM only based only TCM theory such as Wind-damp ,

cold-heat, deficiency-excess, interior-exterior, organs, QI-Blood,

body fluids, essence, fire, dryness ..... All sources of pictorial

diagnosis..........

I 've never heard of this PCOS in TCM ? Are you sure this come

from TCM or from western?

Western medicine has all kind of acronyms, and PCOS is a symptom

or syndrome here in TCM ? With the name here will it tell us what it

is and the formula should be use?

Please do not mix up ! We sometimes mix apples with oranges

together, but we do not call apples the oranges.

I do not think we will call Epstein-Barr Virus (EBV),ACE (Adverse

Childhood Experiences), Acquired Immune Deficiency Syndrome (AIDS),

Acquired Immune Deficiency Syndrome (AIDS),Acquired Immune Deficiency

Syndrome (AIDS),Chronic Fatigue Syndrome (CFS), Chronic Obstructive

Pulmonary Disease (COPD), COPD (Chronic Obstructive Pulmonary

Disease)... are TCM.

With a few acronyms ( millions more to come ) somebody has learned

and memorized in his heart does not mean that he or she knows what to

do. So please do not look down on others who do do recognize THE

acronyms. His jobs is trying to find the patterns and symptoms and

come up with a solution for a patient. That is all which counts.

My friends I have treated some of infertility cases with

successful rates, but it does not mean we are specialist nor experts.

I think sometimes we hit the jackpot.

 

 

Thanks,

Nam Nguyen

 

 

 

 

Chinese Medicine , " David Karchmer "

<acuprof wrote:

>

> Andrea,

>

> Thanks for clarifying. Please understand that I mean no disrespec,

> and I certainly do not doubt your abilities as an acupuncturist. But

> I use your comments as an illustration to those who argue that every

> acupuncturist is equally qualified to treat and manage Infertility

> cases. EVERY acupuncturist who treats infertility regularly knows

> that acronym.

>

> Again, please pardon me if I singled you out or if my comment was

> crass. I beleive that it furthers the point that I am trying to make

> that there exists a genuine and immediate need to give both doctors

> and the general public a means by which they can assess who

> possesses the specialized knowledge and expertise required to

> effectively treat infertility with hacupuncture and TCM.

>

> David Karchmer

>

> Chinese Medicine , Andrea Beth

> Damsky <@> wrote:

> >

> > David,

> >

> > To clarify, I posted the question, and yes, I am a licensed

> acupuncturist. It is true, I had not previously seen the

> acronym " PCOS " for polycystic ovarian syndrome. Nor have I ever

> treated anyone who had been diagnosed with this condition. I do

> know of the diagnosis, but had not heard the acronym before. While

> I have successfully treated women for a wide variety of

> gynecological issues, I do not do fertility medicine. My expertise

> lies in other areas.

> >

> > , MSTOM, LAc, Dipl OM (NCCAOM)

> >

> > David Karchmer <acuprof@> wrote: Right on this very discussion

> board, in the middle of this dialogue

> > about ABORM, and who is or is not qualified to treat infertility

> > somebody posted a very simple question, " What is PCOS? "

> >

> > See message #26271.

> >

> > I presume that the person who posted the question is an

> acupuncturist,

> > as most of us on this discussion board are. So I ask you this, is

> this

> > acupuncturist qualified to treat and manage infertility cases??

> >

> > Those of you who argue against specialty certification and claim

> that

> > all acupuncturists are created equal, do you honestly feel that

> > someone who does not know what PCOS is should be treating

> infertility??

> >

> > There is absolutely nothing wrong with not knowing that. None of

> us

> > knows everything about every syndrome. But this is precisely why

> > specialization and Board Certification in specialized areas is

> needed

> > and is valuable.

> >

> > David Karchmer

> >

> >

> >

> > Subscribe to the fee online journal for TCM at

> Times http://www.chinesemedicinetimes.com

> >

> > Help build the world's largest online encyclopedia for Chinese

> medicine and acupuncture, click,

> http://www.chinesemedicinetimes.com/wiki/CMTpedia

> >

> >

> and

> adjust accordingly.

> >

> > Messages are the property of the author. Any duplication outside

> the group requires prior permission from the author.

> >

> > Please consider the environment and only print this message if

> absolutely necessary.

> >

[Guest guest]

Hi David, I followed this thread with interest. I myself do know what PCOS

stands for, and I can't for the life of me understand how it betters the

treatments I offer in any _significant_ way, or even at all. I don't know how to

fit " PCOS " into a Chinese medical differentiation, especially when even the

source materials on PCOS admit that " not all cases of PCOS will demonstrate the

same symptoms " . Where is the standard?

I also find it interesting that no western infertility specialist would be

disqualified because they did not know the Chinese medical terms blood stasis,

taxation, or spirit-disposition. Of course we can discuss issues regarding

dominant systems and whatnot, but really, logically, there are many cases of

infertility where the (western) specialist _should_ be disqualified for their

lack of understanding of certain realities of the human body. I am astounded at

how people will drop 15 thousand dollars or more on IVF tx with no results, and

yet, magically, do not hold the western specialist accountable. It must be some

mystical ability of the western sage to " know without knowing " .

It would be interesting for you to note for us how knowing about western

medicine's PCOS has helped you define TCM treatments better. Perhaps this might

even bring to light deficiencies in your particular skills at using the tools CM

provides you with.

All said, however, it is clear that practitioners such as yourself have an

important role to play, as do the other practitioners who practice good, solid

CM and also know nothing about PCOS.

And of course, this post only highlights my own particular strengths and

weaknesses. I certainly do not mean to say that western and eastern will never

mix, this is merely a good opportunity for me to raise what I consider to be

interesting, and yes, provocative, points.

Thanks for reading,

Hugo

 

 

 

 

 

David Karchmer <acuprof

Chinese Medicine

Thursday, 6 September, 2007 5:41:43 PM

Re: A case in point

 

 

 

 

 

 

 

 

 

 

 

 

 

Andrea,

 

 

 

Thanks for clarifying. Please understand that I mean no disrespec,

 

and I certainly do not doubt your abilities as an acupuncturist. But

 

I use your comments as an illustration to those who argue that every

 

acupuncturist is equally qualified to treat and manage Infertility

 

cases. EVERY acupuncturist who treats infertility regularly knows

 

that acronym.

 

 

 

Again, please pardon me if I singled you out or if my comment was

 

crass. I beleive that it furthers the point that I am trying to make

 

that there exists a genuine and immediate need to give both doctors

 

and the general public a means by which they can assess who

 

possesses the specialized knowledge and expertise required to

 

effectively treat infertility with hacupuncture and TCM.

 

 

 

David Karchmer

 

 

 

Traditional_ Chinese_Medicine , Andrea Beth

 

Damsky <@.. .> wrote:

 

>

 

> David,

 

>

 

> To clarify, I posted the question, and yes, I am a licensed

 

acupuncturist. It is true, I had not previously seen the

 

acronym " PCOS " for polycystic ovarian syndrome. Nor have I ever

 

treated anyone who had been diagnosed with this condition. I do

 

know of the diagnosis, but had not heard the acronym before. While

 

I have successfully treated women for a wide variety of

 

gynecological issues, I do not do fertility medicine. My expertise

 

lies in other areas.

 

>

 

> , MSTOM, LAc, Dipl OM (NCCAOM)

 

>

 

> David Karchmer <acuprof > wrote: Right on this very discussion

 

board, in the middle of this dialogue

 

> about ABORM, and who is or is not qualified to treat infertility

 

> somebody posted a very simple question, " What is PCOS? "

 

>

 

> See message #26271.

 

>

 

> I presume that the person who posted the question is an

 

acupuncturist,

 

> as most of us on this discussion board are. So I ask you this, is

 

this

 

> acupuncturist qualified to treat and manage infertility cases??

 

>

 

> Those of you who argue against specialty certification and claim

 

that

 

> all acupuncturists are created equal, do you honestly feel that

 

> someone who does not know what PCOS is should be treating

 

infertility? ?

 

>

 

> There is absolutely nothing wrong with not knowing that. None of

 

us

 

> knows everything about every syndrome. But this is precisely why

 

> specialization and Board Certification in specialized areas is

 

needed

 

> and is valuable.

 

>

 

> David Karchmer

 

>

 

>

 

>

 

> Subscribe to the fee online journal for TCM at

 

Times http://www.chinesem edicinetimes. com

 

>

 

> Help build the world's largest online encyclopedia for Chinese

 

medicine and acupuncture, click,

 

http://www.chinesem edicinetimes. com/wiki/ CMTpedia

 

>

 

>

 

http://groups. / group/Traditiona l_Chinese_ Medicine/ join and

 

adjust accordingly.

 

>

 

> Messages are the property of the author. Any duplication outside

 

the group requires prior permission from the author.

 

>

 

> Please consider the environment and only print this message if

 

absolutely necessary.

 

>

[Guest guest]

Nam,

 

I certainly do not, as you suggest, " look down on others who do do

recognize THE acronyms. " But I do assert that if you are unfamiliar

with an acronym as common as PCOS, that you are not experienced in

treating fertility related issues.

 

I understand that TCM and modern western medicine seem like apples

and oranges to many practitioners, but just as agriculture has

hybridized many foods (The Tangelo, the Pluot, etc), such is the

future of Reproductive acupuncture. There is a broadening synthesis

of acupuncture treatment as a complement to western medicine. In the

real world of Oriental Reproductive Medicine, apples and oranges can

no longer remain separate.

 

David Karchmer

 

His jobs is trying to find the patterns and symptoms and

> come up with a solution for a patient. That is all which counts.

> My friends I have treated some of infertility cases with

> successful rates, but it does not mean we are specialist nor

experts.

> I think sometimes we hit the jackpot.

>

>

> Thanks,

> Namhis mean that

> any acupuncturist should recognize this ? Am I also out of the

game?

> I thought TCM only based only TCM theory such as Wind-damp ,

> cold-heat, deficiency-excess, interior-exterior, organs, QI-Blood,

> body fluids, essence, fire, dryness ..... All sources of pictorial

> diagnosis..........

> I 've never heard of this PCOS in TCM ? Are you sure this come

> from TCM or from western?

> Western medicine has all kind of acronyms, and PCOS is a

symptom

> or syndrome here in TCM ? With the name here will it tell us what

it

> is and the formula should be use?

> Please do not mix up ! We sometimes mix apples with oranges

> together, but we do not call apples the oranges.

> I do not think we will call Epstein-Barr Virus (EBV),ACE

(Adverse

> Childhood Experiences), Acquired Immune Deficiency Syndrome (AIDS),

> Acquired Immune Deficiency Syndrome (AIDS),Acquired Immune

Deficiency

> Syndrome (AIDS),Chronic Fatigue Syndrome (CFS), Chronic Obstructive

> Pulmonary Disease (COPD), COPD (Chronic Obstructive Pulmonary

> Disease)... are TCM.

> With a few acronyms ( millions more to come ) somebody has

learned

> and memorized in his heart does not mean that he or she knows what

to

> do. So please do not look down on others who do do recognize THE

> acronyms. His jobs is trying to find the patterns and symptoms and

> come up with a solution for a patient. That is all which counts.

> My friends I have treated some of infertility cases with

> successful rates, but it does not mean we are specialist nor

experts.

> I think sometimes we hit the jackpot.

>

>

> Thanks,

> Nam Nguyen

>

>

>

>

> Chinese Medicine , " David

Karchmer "

> <acuprof@> wrote:

> >

> > Andrea,

> >

> > Thanks for clarifying. Please understand that I mean no

disrespec,

> > and I certainly do not doubt your abilities as an acupuncturist.

But

> > I use your comments as an illustration to those who argue that

every

> > acupuncturist is equally qualified to treat and manage

Infertility

> > cases. EVERY acupuncturist who treats infertility regularly

knows

> > that acronym.

> >

> > Again, please pardon me if I singled you out or if my comment

was

> > crass. I beleive that it furthers the point that I am trying to

make

> > that there exists a genuine and immediate need to give both

doctors

> > and the general public a means by which they can assess who

> > possesses the specialized knowledge and expertise required to

> > effectively treat infertility with hacupuncture and TCM.

> >

> > David Karchmer

> >

> > Chinese Medicine , Andrea Beth

> > Damsky <@> wrote:

> > >

> > > David,

> > >

> > > To clarify, I posted the question, and yes, I am a licensed

> > acupuncturist. It is true, I had not previously seen the

> > acronym " PCOS " for polycystic ovarian syndrome. Nor have I ever

> > treated anyone who had been diagnosed with this condition. I do

> > know of the diagnosis, but had not heard the acronym before.

While

> > I have successfully treated women for a wide variety of

> > gynecological issues, I do not do fertility medicine. My

expertise

> > lies in other areas.

> > >

> > > , MSTOM, LAc, Dipl OM (NCCAOM)

> > >

> > > David Karchmer <acuprof@> wrote: Right on this very discussion

> > board, in the middle of this dialogue

> > > about ABORM, and who is or is not qualified to treat

infertility

> > > somebody posted a very simple question, " What is PCOS? "

> > >

> > > See message #26271.

> > >

> > > I presume that the person who posted the question is an

> > acupuncturist,

> > > as most of us on this discussion board are. So I ask you this,

is

> > this

> > > acupuncturist qualified to treat and manage infertility cases??

> > >

> > > Those of you who argue against specialty certification and

claim

> > that

> > > all acupuncturists are created equal, do you honestly feel

that

> > > someone who does not know what PCOS is should be treating

> > infertility??

> > >

> > > There is absolutely nothing wrong with not knowing that. None

of

> > us

> > > knows everything about every syndrome. But this is precisely

why

> > > specialization and Board Certification in specialized areas is

> > needed

> > > and is valuable.

> > >

> > > David Karchmer

> > >

> > >

> > >

> > > Subscribe to the fee online journal for TCM at Chinese

Medicine

> > Times http://www.chinesemedicinetimes.com

> > >

> > > Help build the world's largest online encyclopedia for Chinese

> > medicine and acupuncture, click,

> > http://www.chinesemedicinetimes.com/wiki/CMTpedia

> > >

> > >

> >

and

> > adjust accordingly.

> > >

> > > Messages are the property of the author. Any duplication

outside

> > the group requires prior permission from the author.

> > >

> > > Please consider the environment and only print this message if

> > absolutely necessary.

> > >

[Guest guest]

David,

Like Hugo, I've also followed this very long discussion without

commenting. While I agree that a modern practitioner of Chinese

medicine does need to know the names of Western diseases such as

polycystic ovarian syndrome, and that knowing the specifics of such

cases, they still have to be translated into Chinese pattern

differentiation with all of its pathomechanisms, systemic information

gained from pulse, questioning, abdominal and tongue diagnosis, and

only then can we treat it. One doesn't have to be ignorant of

biomedicine, but we have to be honest and practice what we were

supposedly trained to do.

 

My concern in integrative settings such as fertility clinics is

that Chinese medicine is not treated like a poor handmaiden, and that

its diagnostics and treatment are not treated with equal respect.

There are criteria for the practice of biomedicine, and criteria for

the practice of Chinese medicine. Neither can be dispensed with.

 

 

On Sep 6, 2007, at 8:13 PM, David Karchmer wrote:

 

> Nam,

>

> I certainly do not, as you suggest, " look down on others who do do

> recognize THE acronyms. " But I do assert that if you are unfamiliar

> with an acronym as common as PCOS, that you are not experienced in

> treating fertility related issues.

>

> I understand that TCM and modern western medicine seem like apples

> and oranges to many practitioners, but just as agriculture has

> hybridized many foods (The Tangelo, the Pluot, etc), such is the

> future of Reproductive acupuncture. There is a broadening synthesis

> of acupuncture treatment as a complement to western medicine. In the

> real world of Oriental Reproductive Medicine, apples and oranges can

> no longer remain separate.

>

> David Karchmer

>

> His jobs is trying to find the patterns and symptoms and

> > come up with a solution for a patient. That is all which counts.

> > My friends I have treated some of infertility cases with

> > successful rates, but it does not mean we are specialist nor

> experts.

> > I think sometimes we hit the jackpot.

> >

> >

> > Thanks,

> > Namhis mean that

> > any acupuncturist should recognize this ? Am I also out of the

> game?

> > I thought TCM only based only TCM theory such as Wind-damp ,

> > cold-heat, deficiency-excess, interior-exterior, organs, QI-Blood,

> > body fluids, essence, fire, dryness ..... All sources of pictorial

> > diagnosis..........

> > I 've never heard of this PCOS in TCM ? Are you sure this come

> > from TCM or from western?

> > Western medicine has all kind of acronyms, and PCOS is a

> symptom

> > or syndrome here in TCM ? With the name here will it tell us what

> it

> > is and the formula should be use?

> > Please do not mix up ! We sometimes mix apples with oranges

> > together, but we do not call apples the oranges.

> > I do not think we will call Epstein-Barr Virus (EBV),ACE

> (Adverse

> > Childhood Experiences), Acquired Immune Deficiency Syndrome (AIDS),

> > Acquired Immune Deficiency Syndrome (AIDS),Acquired Immune

> Deficiency

> > Syndrome (AIDS),Chronic Fatigue Syndrome (CFS), Chronic Obstructive

> > Pulmonary Disease (COPD), COPD (Chronic Obstructive Pulmonary

> > Disease)... are TCM.

> > With a few acronyms ( millions more to come ) somebody has

> learned

> > and memorized in his heart does not mean that he or she knows what

> to

> > do. So please do not look down on others who do do recognize THE

> > acronyms. His jobs is trying to find the patterns and symptoms and

> > come up with a solution for a patient. That is all which counts.

> > My friends I have treated some of infertility cases with

> > successful rates, but it does not mean we are specialist nor

> experts.

> > I think sometimes we hit the jackpot.

> >

> >

> > Thanks,

> > Nam Nguyen

> >

> >

> >

> >

> > Chinese Medicine , " David

> Karchmer "

> > <acuprof@> wrote:

> > >

> > > Andrea,

> > >

> > > Thanks for clarifying. Please understand that I mean no

> disrespec,

> > > and I certainly do not doubt your abilities as an acupuncturist.

> But

> > > I use your comments as an illustration to those who argue that

> every

> > > acupuncturist is equally qualified to treat and manage

> Infertility

> > > cases. EVERY acupuncturist who treats infertility regularly

> knows

> > > that acronym.

> > >

> > > Again, please pardon me if I singled you out or if my comment

> was

> > > crass. I beleive that it furthers the point that I am trying to

> make

> > > that there exists a genuine and immediate need to give both

> doctors

> > > and the general public a means by which they can assess who

> > > possesses the specialized knowledge and expertise required to

> > > effectively treat infertility with hacupuncture and TCM.

> > >

> > > David Karchmer

> > >

> > > Chinese Medicine , Andrea Beth

> > > Damsky <@> wrote:

> > > >

> > > > David,

> > > >

> > > > To clarify, I posted the question, and yes, I am a licensed

> > > acupuncturist. It is true, I had not previously seen the

> > > acronym " PCOS " for polycystic ovarian syndrome. Nor have I ever

> > > treated anyone who had been diagnosed with this condition. I do

> > > know of the diagnosis, but had not heard the acronym before.

> While

> > > I have successfully treated women for a wide variety of

> > > gynecological issues, I do not do fertility medicine. My

> expertise

> > > lies in other areas.

> > > >

> > > > , MSTOM, LAc, Dipl OM (NCCAOM)

> > > >

> > > > David Karchmer <acuprof@> wrote: Right on this very discussion

> > > board, in the middle of this dialogue

> > > > about ABORM, and who is or is not qualified to treat

> infertility

> > > > somebody posted a very simple question, " What is PCOS? "

> > > >

> > > > See message #26271.

> > > >

> > > > I presume that the person who posted the question is an

> > > acupuncturist,

> > > > as most of us on this discussion board are. So I ask you this,

> is

> > > this

> > > > acupuncturist qualified to treat and manage infertility cases??

> > > >

> > > > Those of you who argue against specialty certification and

> claim

> > > that

> > > > all acupuncturists are created equal, do you honestly feel

> that

> > > > someone who does not know what PCOS is should be treating

> > > infertility??

> > > >

> > > > There is absolutely nothing wrong with not knowing that. None

> of

> > > us

> > > > knows everything about every syndrome. But this is precisely

> why

> > > > specialization and Board Certification in specialized areas is

> > > needed

> > > > and is valuable.

> > > >

> > > > David Karchmer

> > > >

> > > >

> > > >

> > > > Subscribe to the fee online journal for TCM at Chinese

> Medicine

> > > Times http://www.chinesemedicinetimes.com

> > > >

> > > > Help build the world's largest online encyclopedia for Chinese

> > > medicine and acupuncture, click,

> > > http://www.chinesemedicinetimes.com/wiki/CMTpedia

> > > >

> > > >

> > >

> and

> > > adjust accordingly.

> > > >

> > > > Messages are the property of the author. Any duplication

> outside

> > > the group requires prior permission from the author.

> > > >

> > > > Please consider the environment and only print this message if

> > > absolutely necessary.

> > > >

[Guest guest]

Hugo,

 

Does a diagnosis of PCOS change the TCM principle, the Diagnosis,

the herbal recommendations? Probably not.

 

I am not trying to make the point that western understanding of

reproductive disorders will directly influence the acupuncture or

herbal prescription.

 

I do, however, believe that a lot of clinical experience in a single

area better equips a practitioner to provide effective treatment in

that area. This is really the most essential argument for

specialization in the very brodest sense. Why specialize at all?

Because seeing the same kinds of cases and patterns over and over

and over againg better endows the practitioner to achieve clinical

success and manage patient expectations.

 

So, is it important to understand the western mechanisms of PCOS in

order to be effective clinically? That is clearly debatable.

 

Is it possible to see case after case after case of female

infertility and not know what PCOS stands for? Highly unlikely to

the point of nearly impossible.

 

The point I am making in the case of an acupuncturist who does not

know what PCOS stands for, or what FSH is, or how to read a sperm

analysis report is not that they are incompetent as acupuncturists,

but that they clearly do not specialize in Reproductive Medicine.

And, as such are likely (not certainly) but very likely to be less

qualified to manage reproductive cases than someone who has enough

clinical experience with reproduction that they could not possibly

evade terms like PCOS, FSH, and the like.

 

It is an indicator of clinical ability rather than a blanket

assessment of any individual practitioner's clinical aptitude. But,

it also highlights for me the very real and immediate need for a

credential like the one the ABORM is offerring that gives the public

and referring physicians an ability to distinguish acupuncturists

who are knowledgeable of Reproductive Medicine from generalists who

dabble.

 

David Karchmer

 

> Hi David, I followed this thread with interest. I myself do know

what PCOS stands for, and I can't for the life of me understand how

it betters the treatments I offer in any _significant_ way, or even

at all. I don't know how to fit " PCOS " into a Chinese medical

differentiation, especially when even the source materials on PCOS

admit that " not all cases of PCOS will demonstrate the same

symptoms " . Where is the standard?

> I also find it interesting that no western infertility specialist

would be disqualified because they did not know the Chinese medical

terms blood stasis, taxation, or spirit-disposition. Of course we

can discuss issues regarding dominant systems and whatnot, but

really, logically, there are many cases of infertility where the

(western) specialist _should_ be disqualified for their lack of

understanding of certain realities of the human body. I am astounded

at how people will drop 15 thousand dollars or more on IVF tx with

no results, and yet, magically, do not hold the western specialist

accountable. It must be some mystical ability of the western sage

to " know without knowing " .

> It would be interesting for you to note for us how knowing about

western medicine's PCOS has helped you define TCM treatments better.

Perhaps this might even bring to light deficiencies in your

particular skills at using the tools CM provides you with.

> All said, however, it is clear that practitioners such as

yourself have an important role to play, as do the other

practitioners who practice good, solid CM and also know nothing

about PCOS.

> And of course, this post only highlights my own particular

strengths and weaknesses. I certainly do not mean to say that

western and eastern will never mix, this is merely a good

opportunity for me to raise what I consider to be interesting, and

yes, provocative, points.

> Thanks for reading,

> Hugo

>

>

>

>

>

> David Karchmer <acuprof

> Chinese Medicine

> Thursday, 6 September, 2007 5:41:43 PM

> Re: A case in point

>

>

>

>

>

>

>

Andrea,

>

>

>

> Thanks for clarifying. Please understand that I mean no disrespec,

>

> and I certainly do not doubt your abilities as an acupuncturist.

But

>

> I use your comments as an illustration to those who argue that

every

>

> acupuncturist is equally qualified to treat and manage Infertility

>

> cases. EVERY acupuncturist who treats infertility regularly knows

>

> that acronym.

>

>

>

> Again, please pardon me if I singled you out or if my comment was

>

> crass. I beleive that it furthers the point that I am trying to

make

>

> that there exists a genuine and immediate need to give both

doctors

>

> and the general public a means by which they can assess who

>

> possesses the specialized knowledge and expertise required to

>

> effectively treat infertility with hacupuncture and TCM.

>

>

>

> David Karchmer

>

>

>

> Traditional_ Chinese_Medicine , Andrea

Beth

>

> Damsky <@ .> wrote:

>

> >

>

> > David,

>

> >

>

> > To clarify, I posted the question, and yes, I am a licensed

>

> acupuncturist. It is true, I had not previously seen the

>

> acronym " PCOS " for polycystic ovarian syndrome. Nor have I ever

>

> treated anyone who had been diagnosed with this condition. I do

>

> know of the diagnosis, but had not heard the acronym before.

While

>

> I have successfully treated women for a wide variety of

>

> gynecological issues, I do not do fertility medicine. My

expertise

>

> lies in other areas.

>

> >

>

> > , MSTOM, LAc, Dipl OM (NCCAOM)

>

> >

>

> > David Karchmer <acuprof@ > wrote: Right on this very discussion

>

> board, in the middle of this dialogue

>

> > about ABORM, and who is or is not qualified to treat infertility

>

> > somebody posted a very simple question, " What is PCOS? "

>

> >

>

> > See message #26271.

>

> >

>

> > I presume that the person who posted the question is an

>

> acupuncturist,

>

> > as most of us on this discussion board are. So I ask you this,

is

>

> this

>

> > acupuncturist qualified to treat and manage infertility cases??

>

> >

>

> > Those of you who argue against specialty certification and claim

>

> that

>

> > all acupuncturists are created equal, do you honestly feel that

>

> > someone who does not know what PCOS is should be treating

>

> infertility? ?

>

> >

>

> > There is absolutely nothing wrong with not knowing that. None of

>

> us

>

> > knows everything about every syndrome. But this is precisely why

>

> > specialization and Board Certification in specialized areas is

>

> needed

>

> > and is valuable.

>

> >

>

> > David Karchmer

>

> >

>

> >

>

> >

>

> > Subscribe to the fee online journal for TCM at

>

> Times http://www.chinesem edicinetimes. com

>

> >

>

> > Help build the world's largest online encyclopedia for Chinese

>

> medicine and acupuncture, click,

>

> http://www.chinesem edicinetimes. com/wiki/ CMTpedia

>

> >

>

> >

>

> http://groups. / group/Traditiona l_Chinese_ Medicine/

join and

>

> adjust accordingly.

>

> >

>

> > Messages are the property of the author. Any duplication outside

>

> the group requires prior permission from the author.

>

> >

>

> > Please consider the environment and only print this message if

>

> absolutely necessary.

>

> >

[Guest guest]

Hugo,

 

One other point I'd like to make since re-reading your last post.

 

You said, " I am astounded at how people will drop 15 thousand

dollars or more on IVF tx with no results, and yet, magically, do

not hold the western specialist accountable. It must be some

mystical ability of the western sage to " know without knowing " .

-------------------------------

The thing about IVF is that it is not 100% effective. In general,

human reproduction is a very inefficient system.

 

If you took 100 healthy 25 year old couples in perfect reproductive

health, and all of these 100 couples had unprotected sex during the

woman's ovulation, do you know how many would be expected to

conceive?

 

About 20-25 out of the 100 couples. With each attempt, health 25

year old couples can expect about a 20-25% chance of conception.

Said another way, human reproduction amounts to a 75% failure rate

per attempt.

 

Now, add to the mix age, health problems, hormonal problems,

surgeries, etc., and of course, the odds go down.

 

Assisted reproductive technologies like IVF have MUCH HIGHER rates

of success than the old fashioned, " natural approach. " Still, the

success rate is not 100%. In fact, it is not even close to that.

 

But, all infertility clinics are required to report their statistics

to the CDC, and most clinics post their success rates on their

websites. Furthermore, most (if not all) RE's inform couples of the

statistical probabilities of success before any procedures take

place. So, the reason (i think) that many people do not hold their

physician or IVF clinic responsible for a failed cycle is that

failure is a very probable outcome, and this is understood by all

parties from the very start.

 

If a doctor told his or her patients that they had a 99% chance of

success, and then the cycle failed.........I could see why people

would, as you say, " hold the western specialist accountable. " But,

that is just not the case, and most people understand the bargain

from the get go.

 

David Karchmer

 

 

Chinese Medicine , Hugo Ramiro

<subincor wrote:

>

> Hi David, I followed this thread with interest. I myself do know

what PCOS stands for, and I can't for the life of me understand how

it betters the treatments I offer in any _significant_ way, or even

at all. I don't know how to fit " PCOS " into a Chinese medical

differentiation, especially when even the source materials on PCOS

admit that " not all cases of PCOS will demonstrate the same

symptoms " . Where is the standard?

> I also find it interesting that no western infertility specialist

would be disqualified because they did not know the Chinese medical

terms blood stasis, taxation, or spirit-disposition. Of course we

can discuss issues regarding dominant systems and whatnot, but

really, logically, there are many cases of infertility where the

(western) specialist _should_ be disqualified for their lack of

understanding of certain realities of the human body. I am astounded

at how people will drop 15 thousand dollars or more on IVF tx with

no results, and yet, magically, do not hold the western specialist

accountable. It must be some mystical ability of the western sage

to " know without knowing " .

> It would be interesting for you to note for us how knowing about

western medicine's PCOS has helped you define TCM treatments better.

Perhaps this might even bring to light deficiencies in your

particular skills at using the tools CM provides you with.

> All said, however, it is clear that practitioners such as

yourself have an important role to play, as do the other

practitioners who practice good, solid CM and also know nothing

about PCOS.

> And of course, this post only highlights my own particular

strengths and weaknesses. I certainly do not mean to say that

western and eastern will never mix, this is merely a good

opportunity for me to raise what I consider to be interesting, and

yes, provocative, points.

> Thanks for reading,

> Hugo

>

>

>

>

>

> David Karchmer <acuprof

> Chinese Medicine

> Thursday, 6 September, 2007 5:41:43 PM

> Re: A case in point

>

>

>

>

>

>

>

Andrea,

>

>

>

> Thanks for clarifying. Please understand that I mean no disrespec,

>

> and I certainly do not doubt your abilities as an acupuncturist.

But

>

> I use your comments as an illustration to those who argue that

every

>

> acupuncturist is equally qualified to treat and manage Infertility

>

> cases. EVERY acupuncturist who treats infertility regularly knows

>

> that acronym.

>

>

>

> Again, please pardon me if I singled you out or if my comment was

>

> crass. I beleive that it furthers the point that I am trying to

make

>

> that there exists a genuine and immediate need to give both

doctors

>

> and the general public a means by which they can assess who

>

> possesses the specialized knowledge and expertise required to

>

> effectively treat infertility with hacupuncture and TCM.

>

>

>

> David Karchmer

>

>

>

> Traditional_ Chinese_Medicine , Andrea

Beth

>

> Damsky <@ .> wrote:

>

> >

>

> > David,

>

> >

>

> > To clarify, I posted the question, and yes, I am a licensed

>

> acupuncturist. It is true, I had not previously seen the

>

> acronym " PCOS " for polycystic ovarian syndrome. Nor have I ever

>

> treated anyone who had been diagnosed with this condition. I do

>

> know of the diagnosis, but had not heard the acronym before.

While

>

> I have successfully treated women for a wide variety of

>

> gynecological issues, I do not do fertility medicine. My

expertise

>

> lies in other areas.

>

> >

>

> > , MSTOM, LAc, Dipl OM (NCCAOM)

>

> >

>

> > David Karchmer <acuprof@ > wrote: Right on this very discussion

>

> board, in the middle of this dialogue

>

> > about ABORM, and who is or is not qualified to treat infertility

>

> > somebody posted a very simple question, " What is PCOS? "

>

> >

>

> > See message #26271.

>

> >

>

> > I presume that the person who posted the question is an

>

> acupuncturist,

>

> > as most of us on this discussion board are. So I ask you this,

is

>

> this

>

> > acupuncturist qualified to treat and manage infertility cases??

>

> >

>

> > Those of you who argue against specialty certification and claim

>

> that

>

> > all acupuncturists are created equal, do you honestly feel that

>

> > someone who does not know what PCOS is should be treating

>

> infertility? ?

>

> >

>

> > There is absolutely nothing wrong with not knowing that. None of

>

> us

>

> > knows everything about every syndrome. But this is precisely why

>

> > specialization and Board Certification in specialized areas is

>

> needed

>

> > and is valuable.

>

> >

>

> > David Karchmer

>

> >

>

> >

>

> >

>

> > Subscribe to the fee online journal for TCM at

>

> Times http://www.chinesem edicinetimes. com

>

> >

>

> > Help build the world's largest online encyclopedia for Chinese

>

> medicine and acupuncture, click,

>

> http://www.chinesem edicinetimes. com/wiki/ CMTpedia

>

> >

>

> >

>

> http://groups. / group/Traditiona l_Chinese_ Medicine/

join and

>

> adjust accordingly.

>

> >

>

> > Messages are the property of the author. Any duplication outside

>

> the group requires prior permission from the author.

>

> >

>

> > Please consider the environment and only print this message if

>

> absolutely necessary.

>

> >

[Guest guest]

I guess I'll throw in my two cents since infertility and obstetrics are two

specialties in my

practice.

 

I'd say the bottom line is - what gives the best competitive advantage over

others, if that's

what this is about, is having lots of lovely pregnant women and beautiful babies

in your

practice as a result of your care. It won't matter if you are certified, have a

Ph.D., an OMD,

or an XYZ. When you get results, patients will come to you.

 

And yes, getting up to speed in the nomenclature and facts of reproductive

medicine is

essential, I believe. But whether you acquire that knowledge through school

(unlikely,

unfortunately), through a certification program, or through self-study, it

doesn't matter.

The ABORM program may provide lots of great information, but the true test will

be

whether its certified practitioners can get great results with their infertility

patients. I hope

they do.

 

As for the PCOS issue - I have to admit I am embarrassed that it's within the

norm for

people in our profession to not know this acronym, among others - a reflection

of our

schools. I believe strongly that we do need to be familiar with both eastern and

western

medicine to be excellent practitioners, if for no other reason than to recognize

a potential

emergency - like an ectopic pregnancy. Any master teacher I have studied with

from China

or Japan or the US has been fluent in both WM and OM, with a deep emphasis on

OM.

 

If our profession keeps growing, I believe that definition should go both ways.

An

excellent WM practitioner needs to be familiar with OM as well.

 

As for the importance of a WM diagnosis, my patients get much better results if

I know

they have a PCOS diagnosis than if I go by OM signs and symptoms alone and treat

damp

stagnation with kidney jing deficiency and liver qi stagnation, for example.

Maybe I would

get lucky without knowing about the condition, but there are specific PCOS

protocols from

China that I modify based on the OM diagnosis that are far more effective.

Familiarity with

the WM diagnosis deepens my understanding of the pathology, improves my

treatment

plan, and improves my ability to track progress not just through OM diagnosis

but WM

diagnositc measures as well, which improves communication with the patient and

their

doctor. You could argue that the last items aren't critical, but they sure help

OM credibility

and get me more referrals!

 

Most of all, in my experience, combining strong western medicine knowledge with

strong

OM skill works to the best advantage of the patient.

 

Good luck.

 

Abigail

[Guest guest]

Thank you Nam,

 

I, too base my diagnoses and treatment protocols according to the TCM patterns

my patients come in with. There have been other patients I've seen who also had

other western medical diagnoses with acronyms I've not heard of before, and even

rare diseases I'd not learned about in school. However, I was able to treat

them just fine according to TCM principles. I have also been able to (and this

is my specialty) help patients whose endless parade of specialty western doctors

could neither diagnose nor treat them effectively. I believe that any

acupuncturist worth their salt will do research on behalf of their patients with

western diagnoses (and acronyms) they had not been previously familiar with;

this is just common sense. I think it is foolish to justify the creation of a

specialty board on the basis that we are not fully trained in western medicine;

of course we are not, that is not the basis of our licenses.

 

So, to throw a curve at you all, how many of you have heard of Harada's Disease?

Clue: it is a western medical diagnosis. Another clue: it is not a reproductive

disease or syndrome. Answer to follow...

 

(etc.)

 

dr_namnguyen58 <dr_namnguyen58 wrote: Dear David,

 

I am sure I did not know the acronym PCOS. Does this mean that

any acupuncturist should recognize this ? Am I also out of the game?

I thought TCM only based only TCM theory such as Wind-damp ,

cold-heat, deficiency-excess, interior-exterior, organs, QI-Blood,

body fluids, essence, fire, dryness ..... All sources of pictorial

diagnosis..........

I 've never heard of this PCOS in TCM ? Are you sure this come

from TCM or from western?

Western medicine has all kind of acronyms, and PCOS is a symptom

or syndrome here in TCM ? With the name here will it tell us what it

is and the formula should be use?

Please do not mix up ! We sometimes mix apples with oranges

together, but we do not call apples the oranges.

I do not think we will call Epstein-Barr Virus (EBV),ACE (Adverse

Childhood Experiences), Acquired Immune Deficiency Syndrome (AIDS),

Acquired Immune Deficiency Syndrome (AIDS),Acquired Immune Deficiency

Syndrome (AIDS),Chronic Fatigue Syndrome (CFS), Chronic Obstructive

Pulmonary Disease (COPD), COPD (Chronic Obstructive Pulmonary

Disease)... are TCM.

With a few acronyms ( millions more to come ) somebody has learned

and memorized in his heart does not mean that he or she knows what to

do. So please do not look down on others who do do recognize THE

acronyms. His jobs is trying to find the patterns and symptoms and

come up with a solution for a patient. That is all which counts.

My friends I have treated some of infertility cases with

successful rates, but it does not mean we are specialist nor experts.

I think sometimes we hit the jackpot.

 

 

Thanks,

Nam Nguyen

 

 

 

 

Chinese Medicine , " David Karchmer "

wrote:

>

> Andrea,

>

> Thanks for clarifying. Please understand that I mean no disrespec,

> and I certainly do not doubt your abilities as an acupuncturist. But

> I use your comments as an illustration to those who argue that every

> acupuncturist is equally qualified to treat and manage Infertility

> cases. EVERY acupuncturist who treats infertility regularly knows

> that acronym.

>

> Again, please pardon me if I singled you out or if my comment was

> crass. I beleive that it furthers the point that I am trying to make

> that there exists a genuine and immediate need to give both doctors

> and the general public a means by which they can assess who

> possesses the specialized knowledge and expertise required to

> effectively treat infertility with hacupuncture and TCM.

>

> David Karchmer

>

> Chinese Medicine , Andrea Beth

> Damsky wrote:

> >

> > David,

> >

> > To clarify, I posted the question, and yes, I am a licensed

> acupuncturist. It is true, I had not previously seen the

> acronym " PCOS " for polycystic ovarian syndrome. Nor have I ever

> treated anyone who had been diagnosed with this condition. I do

> know of the diagnosis, but had not heard the acronym before. While

> I have successfully treated women for a wide variety of

> gynecological issues, I do not do fertility medicine. My expertise

> lies in other areas.

> >

> > , MSTOM, LAc, Dipl OM (NCCAOM)

> >

> > David Karchmer wrote: Right on this very discussion

> board, in the middle of this dialogue

> > about ABORM, and who is or is not qualified to treat infertility

> > somebody posted a very simple question, " What is PCOS? "

> >

> > See message #26271.

> >

> > I presume that the person who posted the question is an

> acupuncturist,

> > as most of us on this discussion board are. So I ask you this, is

> this

> > acupuncturist qualified to treat and manage infertility cases??

> >

> > Those of you who argue against specialty certification and claim

> that

> > all acupuncturists are created equal, do you honestly feel that

> > someone who does not know what PCOS is should be treating

> infertility??

> >

> > There is absolutely nothing wrong with not knowing that. None of

> us

> > knows everything about every syndrome. But this is precisely why

> > specialization and Board Certification in specialized areas is

> needed

> > and is valuable.

> >

> > David Karchmer

> >

> >

> >

> > Subscribe to the fee online journal for TCM at

> Times http://www.chinesemedicinetimes.com

> >

> > Help build the world's largest online encyclopedia for Chinese

> medicine and acupuncture, click,

> http://www.chinesemedicinetimes.com/wiki/CMTpedia

> >

> >

> and

> adjust accordingly.

> >

> > Messages are the property of the author. Any duplication outside

> the group requires prior permission from the author.

> >

> > Please consider the environment and only print this message if

> absolutely necessary.

> >

[Guest guest]

Andrea,

 

Please, let me be the first to say, I'VE NEVER HEARD OF IT.

 

David

 

Chinese Medicine , Andrea Beth

Damsky < wrote:

>

> Thank you Nam,

>

> I, too base my diagnoses and treatment protocols according to the

TCM patterns my patients come in with. There have been other

patients I've seen who also had other western medical diagnoses with

acronyms I've not heard of before, and even rare diseases I'd not

learned about in school. However, I was able to treat them just

fine according to TCM principles. I have also been able to (and

this is my specialty) help patients whose endless parade of

specialty western doctors could neither diagnose nor treat them

effectively. I believe that any acupuncturist worth their salt will

do research on behalf of their patients with western diagnoses (and

acronyms) they had not been previously familiar with; this is just

common sense. I think it is foolish to justify the creation of a

specialty board on the basis that we are not fully trained in

western medicine; of course we are not, that is not the basis of our

licenses.

>

> So, to throw a curve at you all, how many of you have heard of

Harada's Disease? Clue: it is a western medical diagnosis. Another

clue: it is not a reproductive disease or syndrome. Answer to

follow...

>

> (etc.)

>

> dr_namnguyen58 <dr_namnguyen58 wrote: Dear David,

>

> I am sure I did not know the acronym PCOS. Does this mean that

> any acupuncturist should recognize this ? Am I also out of the

game?

> I thought TCM only based only TCM theory such as Wind-damp ,

> cold-heat, deficiency-excess, interior-exterior, organs, QI-Blood,

> body fluids, essence, fire, dryness ..... All sources of pictorial

> diagnosis..........

> I 've never heard of this PCOS in TCM ? Are you sure this come

> from TCM or from western?

> Western medicine has all kind of acronyms, and PCOS is a

symptom

> or syndrome here in TCM ? With the name here will it tell us what

it

> is and the formula should be use?

> Please do not mix up ! We sometimes mix apples with oranges

> together, but we do not call apples the oranges.

> I do not think we will call Epstein-Barr Virus (EBV),ACE

(Adverse

> Childhood Experiences), Acquired Immune Deficiency Syndrome (AIDS),

> Acquired Immune Deficiency Syndrome (AIDS),Acquired Immune

Deficiency

> Syndrome (AIDS),Chronic Fatigue Syndrome (CFS), Chronic Obstructive

> Pulmonary Disease (COPD), COPD (Chronic Obstructive Pulmonary

> Disease)... are TCM.

> With a few acronyms ( millions more to come ) somebody has

learned

> and memorized in his heart does not mean that he or she knows what

to

> do. So please do not look down on others who do do recognize THE

> acronyms. His jobs is trying to find the patterns and symptoms and

> come up with a solution for a patient. That is all which counts.

> My friends I have treated some of infertility cases with

> successful rates, but it does not mean we are specialist nor

experts.

> I think sometimes we hit the jackpot.

>

>

> Thanks,

> Nam Nguyen

>

>

>

>

> Chinese Medicine , " David

Karchmer "

> wrote:

> >

> > Andrea,

> >

> > Thanks for clarifying. Please understand that I mean no

disrespec,

> > and I certainly do not doubt your abilities as an acupuncturist.

But

> > I use your comments as an illustration to those who argue that

every

> > acupuncturist is equally qualified to treat and manage

Infertility

> > cases. EVERY acupuncturist who treats infertility regularly

knows

> > that acronym.

> >

> > Again, please pardon me if I singled you out or if my comment

was

> > crass. I beleive that it furthers the point that I am trying to

make

> > that there exists a genuine and immediate need to give both

doctors

> > and the general public a means by which they can assess who

> > possesses the specialized knowledge and expertise required to

> > effectively treat infertility with hacupuncture and TCM.

> >

> > David Karchmer

> >

> > Chinese Medicine , Andrea Beth

> > Damsky wrote:

> > >

> > > David,

> > >

> > > To clarify, I posted the question, and yes, I am a licensed

> > acupuncturist. It is true, I had not previously seen the

> > acronym " PCOS " for polycystic ovarian syndrome. Nor have I ever

> > treated anyone who had been diagnosed with this condition. I do

> > know of the diagnosis, but had not heard the acronym before.

While

> > I have successfully treated women for a wide variety of

> > gynecological issues, I do not do fertility medicine. My

expertise

> > lies in other areas.

> > >

> > > , MSTOM, LAc, Dipl OM (NCCAOM)

> > >

> > > David Karchmer wrote: Right on this very discussion

> > board, in the middle of this dialogue

> > > about ABORM, and who is or is not qualified to treat

infertility

> > > somebody posted a very simple question, " What is PCOS? "

> > >

> > > See message #26271.

> > >

> > > I presume that the person who posted the question is an

> > acupuncturist,

> > > as most of us on this discussion board are. So I ask you this,

is

> > this

> > > acupuncturist qualified to treat and manage infertility cases??

> > >

> > > Those of you who argue against specialty certification and

claim

> > that

> > > all acupuncturists are created equal, do you honestly feel

that

> > > someone who does not know what PCOS is should be treating

> > infertility??

> > >

> > > There is absolutely nothing wrong with not knowing that. None

of

> > us

> > > knows everything about every syndrome. But this is precisely

why

> > > specialization and Board Certification in specialized areas is

> > needed

> > > and is valuable.

> > >

> > > David Karchmer

> > >

> > >

> > >

> > > Subscribe to the fee online journal for TCM at Chinese

Medicine

> > Times http://www.chinesemedicinetimes.com

> > >

> > > Help build the world's largest online encyclopedia for Chinese

> > medicine and acupuncture, click,

> > http://www.chinesemedicinetimes.com/wiki/CMTpedia

> > >

> > >

> >

and

> > adjust accordingly.

> > >

> > > Messages are the property of the author. Any duplication

outside

> > the group requires prior permission from the author.

> > >

> > > Please consider the environment and only print this message if

> > absolutely necessary.

> > >

[Guest guest]

Z'ev,

 

I agree that I would prefer to see practiced as a

complement to Awestern medicine without having to compromise its

rich depth and scope. This would certainly be preferable to a

watered down, cookbook collection of protocols. However, I believe

that there are two necessary stepping stones that need to be treaded

in order to acheive this ultimate goal.

 

1) The process has to start, and we have to start where we are with

what is currently available. If western clinics are willing to

utilize acupuncture as a standardized, evidence based

protocol.........I think we should take it. I do not think it

behooves our profession to take a moralistic and inflexible position

wherein we refuse to participate unless we can do it purely on our

oewn terms. By starting the process (even on a limited and less than

ideal basis), I think we will have a chance to grow and develop

within the western clinical framework.

 

2) We need more and better research in the area of differential

diagnosis nad Chinese Herbal Medicine. The more evidence-based

reasearch that confirms the efficacy of Differential Diagnosis nad

Herbal Medicine, the more likely we will be able to integrate true

into western hospitals and clinics.

 

David Karchmer

 

 

Chinese Medicine , " Z'ev

Rosenberg " <zrosenbe wrote:

>

> David,

> Like Hugo, I've also followed this very long discussion

without

> commenting. While I agree that a modern practitioner of Chinese

> medicine does need to know the names of Western diseases such as

> polycystic ovarian syndrome, and that knowing the specifics of

such

> cases, they still have to be translated into Chinese pattern

> differentiation with all of its pathomechanisms, systemic

information

> gained from pulse, questioning, abdominal and tongue diagnosis,

and

> only then can we treat it. One doesn't have to be ignorant of

> biomedicine, but we have to be honest and practice what we were

> supposedly trained to do.

>

> My concern in integrative settings such as fertility clinics

is

> that Chinese medicine is not treated like a poor handmaiden, and

that

> its diagnostics and treatment are not treated with equal

respect.

> There are criteria for the practice of biomedicine, and criteria

for

> the practice of Chinese medicine. Neither can be dispensed with.

>

>

> On Sep 6, 2007, at 8:13 PM, David Karchmer wrote:

>

> > Nam,

> >

> > I certainly do not, as you suggest, " look down on others who do

do

> > recognize THE acronyms. " But I do assert that if you are

unfamiliar

> > with an acronym as common as PCOS, that you are not experienced

in

> > treating fertility related issues.

> >

> > I understand that TCM and modern western medicine seem like

apples

> > and oranges to many practitioners, but just as agriculture has

> > hybridized many foods (The Tangelo, the Pluot, etc), such is the

> > future of Reproductive acupuncture. There is a broadening

synthesis

> > of acupuncture treatment as a complement to western medicine. In

the

> > real world of Oriental Reproductive Medicine, apples and oranges

can

> > no longer remain separate.

> >

> > David Karchmer

> >

> > His jobs is trying to find the patterns and symptoms and

> > > come up with a solution for a patient. That is all which

counts.

> > > My friends I have treated some of infertility cases with

> > > successful rates, but it does not mean we are specialist nor

> > experts.

> > > I think sometimes we hit the jackpot.

> > >

> > >

> > > Thanks,

> > > Namhis mean that

> > > any acupuncturist should recognize this ? Am I also out of the

> > game?

> > > I thought TCM only based only TCM theory such as Wind-damp ,

> > > cold-heat, deficiency-excess, interior-exterior, organs, QI-

Blood,

> > > body fluids, essence, fire, dryness ..... All sources of

pictorial

> > > diagnosis..........

> > > I 've never heard of this PCOS in TCM ? Are you sure this come

> > > from TCM or from western?

> > > Western medicine has all kind of acronyms, and PCOS is a

> > symptom

> > > or syndrome here in TCM ? With the name here will it tell us

what

> > it

> > > is and the formula should be use?

> > > Please do not mix up ! We sometimes mix apples with oranges

> > > together, but we do not call apples the oranges.

> > > I do not think we will call Epstein-Barr Virus (EBV),ACE

> > (Adverse

> > > Childhood Experiences), Acquired Immune Deficiency Syndrome

(AIDS),

> > > Acquired Immune Deficiency Syndrome (AIDS),Acquired Immune

> > Deficiency

> > > Syndrome (AIDS),Chronic Fatigue Syndrome (CFS), Chronic

Obstructive

> > > Pulmonary Disease (COPD), COPD (Chronic Obstructive Pulmonary

> > > Disease)... are TCM.

> > > With a few acronyms ( millions more to come ) somebody has

> > learned

> > > and memorized in his heart does not mean that he or she knows

what

> > to

> > > do. So please do not look down on others who do do recognize

THE

> > > acronyms. His jobs is trying to find the patterns and symptoms

and

> > > come up with a solution for a patient. That is all which

counts.

> > > My friends I have treated some of infertility cases with

> > > successful rates, but it does not mean we are specialist nor

> > experts.

> > > I think sometimes we hit the jackpot.

> > >

> > >

> > > Thanks,

> > > Nam Nguyen

> > >

> > >

> > >

> > >

> > > Chinese Medicine , " David

> > Karchmer "

> > > <acuprof@> wrote:

> > > >

> > > > Andrea,

> > > >

> > > > Thanks for clarifying. Please understand that I mean no

> > disrespec,

> > > > and I certainly do not doubt your abilities as an

acupuncturist.

> > But

> > > > I use your comments as an illustration to those who argue

that

> > every

> > > > acupuncturist is equally qualified to treat and manage

> > Infertility

> > > > cases. EVERY acupuncturist who treats infertility regularly

> > knows

> > > > that acronym.

> > > >

> > > > Again, please pardon me if I singled you out or if my comment

> > was

> > > > crass. I beleive that it furthers the point that I am trying

to

> > make

> > > > that there exists a genuine and immediate need to give both

> > doctors

> > > > and the general public a means by which they can assess who

> > > > possesses the specialized knowledge and expertise required to

> > > > effectively treat infertility with hacupuncture and TCM.

> > > >

> > > > David Karchmer

> > > >

> > > > Chinese Medicine , Andrea

Beth

> > > > Damsky <@> wrote:

> > > > >

> > > > > David,

> > > > >

> > > > > To clarify, I posted the question, and yes, I am a licensed

> > > > acupuncturist. It is true, I had not previously seen the

> > > > acronym " PCOS " for polycystic ovarian syndrome. Nor have I

ever

> > > > treated anyone who had been diagnosed with this condition. I

do

> > > > know of the diagnosis, but had not heard the acronym before.

> > While

> > > > I have successfully treated women for a wide variety of

> > > > gynecological issues, I do not do fertility medicine. My

> > expertise

> > > > lies in other areas.

> > > > >

> > > > > , MSTOM, LAc, Dipl OM (NCCAOM)

> > > > >

> > > > > David Karchmer <acuprof@> wrote: Right on this very

discussion

> > > > board, in the middle of this dialogue

> > > > > about ABORM, and who is or is not qualified to treat

> > infertility

> > > > > somebody posted a very simple question, " What is PCOS? "

> > > > >

> > > > > See message #26271.

> > > > >

> > > > > I presume that the person who posted the question is an

> > > > acupuncturist,

> > > > > as most of us on this discussion board are. So I ask you

this,

> > is

> > > > this

> > > > > acupuncturist qualified to treat and manage infertility

cases??

> > > > >

> > > > > Those of you who argue against specialty certification and

> > claim

> > > > that

> > > > > all acupuncturists are created equal, do you honestly feel

> > that

> > > > > someone who does not know what PCOS is should be treating

> > > > infertility??

> > > > >

> > > > > There is absolutely nothing wrong with not knowing that.

None

> > of

> > > > us

> > > > > knows everything about every syndrome. But this is

precisely

> > why

> > > > > specialization and Board Certification in specialized

areas is

> > > > needed

> > > > > and is valuable.

> > > > >

> > > > > David Karchmer

> > > > >

> > > > >

> > > > >

> > > > > Subscribe to the fee online journal for TCM at Chinese

> > Medicine

> > > > Times http://www.chinesemedicinetimes.com

> > > > >

> > > > > Help build the world's largest online encyclopedia for

Chinese

> > > > medicine and acupuncture, click,

> > > > http://www.chinesemedicinetimes.com/wiki/CMTpedia

> > > > >

> > > > >

> > > >

 

> > and

> > > > adjust accordingly.

> > > > >

> > > > > Messages are the property of the author. Any duplication

> > outside

> > > > the group requires prior permission from the author.

> > > > >

> > > > > Please consider the environment and only print this

message if

> > > > absolutely necessary.

> > > > >

[Guest guest]

David,

In many ways, we are in agreement. We both want to see the practice

of deepen its roots in our culture.

 

I do not agree, however, that this is " just about marketing. " It is

also about competence, clincal experience, the development of

spcific expertise, and research.

 

I also do not equate the deepening of the knowledge of Chinese

Medicine with a purely backward looking approach - toward classic

texts and lineage traditions. Rather, I see the future of Chinese

Medicine and the deepening of our knowleddge as being research and

evidence based.

 

I do not accept the " facts " of because a famous

doctor wrote his data in a book 1,000 years ago. I would like to see

(both in principle and in practice) subjected to

solid scientific research. This is my mission and my passion, and I

think that one of the best ways to accomplish this is to team up

with the western medical and scientific community.

 

How to best forge these connections? By understanding both the

nomenclature and the principles that govern the western medicine and

research.

 

I do not feel animosity toward more classical approaches to Chinese

Medicine, I think this will always have a place in our culture. But

I think integration is the future and the fate of integration lies

in quality evidence-based research.

 

David Karchmer

 

--- In

Chinese Medicine , " flyingstarsfengshui "

<flyingstarsfengshui wrote:

>

> Hi David:

>

> Its me again!

>

> Much of these discussions center around " Marketing " , how best can

> people market themselves to to the western medical community. Lets

> not mix that with practicing , with a marketing

> strategy comes choices and compromises, lets not mix these choices

> and compromises with practicing the best chinese medicine we can.

> Lets atleast call it like it is, with no judgement. And I dont

think

> we need to comprise our protocols and methods to work with the

> western medical community.

>

> I see a strong passion for increasing the knowledge of Western

> Medicine in our profession, I think this is great. What I don't

see

> is the same kind of passion and push for the increased study of

> Acupuncture, I mean a deep study of the classics, a deep study of

> things most practioners only dabble in that are crucual to

> practicing , particularly Acupuncture.

>

> Let me share an example. For many people useing the Eight

> Extraordinary Channels they use the " Command Points/Opening

Points "

> and believe they are doing an EE treatment. Many practitioners do

> not know these points are not in the Nei Jing, not in the Nan

Jing,

> not in the Jia Yi Jing, they were revealed around 1200 AD, over

1500

> years after the formation of the Nei Jing, and the person who

> revealed them gave no theory to support it. In the Ming dyansty

> these points and channels began to be used, they did not always

use

> these Command Points in treatments, they always used EE pathway

> points, in a eloquent and strategic way, this is an EE treatment,

> and the command points may or my not be added.

>

> In my view all the Secondary Vessels are not used properly by

many,

> and books on the market, especially state board books, are

> inadequete.

>

> I can argue that if practitioners do not know how to use the

> secondary vessels they are not competent practitioners and not

> qualified to practice chinese medicine. How would you feel if a

> group began to promote this and began to ask you questions which

you

> may not know the answers to expose your knowledge on a core aspect

> of Acupuncture, but has been primarly ignored by modern

> practitioners?

>

> Aside from the ramifications of Marketing, my real point is I hope

> people will get involved with a passion to expand our knowledge of

> Acupuncture, way beyond ZangFu, in the same way I see the

intensity

> with Western Medical Knowledge. This is my mission, which I try to

> express as a teacher and writer and hope others who do this

continue

> and more join us.

>

> Also, I'm happy to see more people expressing their views on

ABORM,

> this is a small community and these forums are far reaching and do

> have an influence.

>

>

> Best Wishes,

>

> David

>

[Guest guest]

David,

 

Again I want to reiterate that I think that we are more aligned than

opposed on this. And I think it is important to refresh that idea as

we continue to discuss/debate some of the finer points.

 

You stated,

 

" Teaming up is good. But the research should follow our practice, to

follow Chinese medical applications, not some western model of

acupuncture. "

 

I ask, how in the world will this ever be accomplished if WE (the

acupuncturists) are not deeply involved in the research process?

Who will bring true (whatever that is) into valid

scientific scrutiny if not us, the acupuncturists?

*****************************************************************

You continued:

 

" Science doe not yet have the technology to measure how acupuncture

works, does not have the vehicle to measure how we view the human

body. "

 

True. And 30 years ago we didn't have the technology to do IVF or

replace a heart with a machine. Now we do. So, science does develop

and evolve, but again I ask, How will it evolve toward quantifying

the principles of if we are content to accept what

is already known and do not drive toward such

scrutiny?

**************************************************************

 

You continued:

 

" Scientific tools must evolve to being able to measure the

range of what our medicine can do, it can measure some things, lets

not be defined by a western medical model. "

 

Agreed. See my above response.

********************************************************************

On a philosophical note. I do not accept as

inherently valid. and the classical texts in which

its principles are delineated, is not an article of faith for me.

 

is a science, not a religion. I do not feel that it

should be accepted blindly by virtue of its long and rich heritage.

If it works, it is true. If it does not, it isn't no matter what the

God-Damned Classics say!

 

And if CM DOES work, then it should be able to be quantified and

scientifically verified. But if we do not drive it " under the

microscope, " then who will?

 

I realize that this is not necessarily a popular view, and it

certainly is not a glamorous one. I realize that this view will

offend Fundamentalists. But I think that a " show

Me " skepticism is healthy, even among practitioners of acupuncture

and CM. Blind acceptance causes stagnation. Curiosity and skepticism

drive inquiry and progress.

 

David Karchmer

 

 

--- In

Chinese Medicine , " flyingstarsfengshui "

<flyingstarsfengshui wrote:

>

> Hi David:

>

> Below your comments is my feedback.

>

>

> I do not agree, however, that this is " just about marketing. " It is

> also about competence, clincal experience, the development of

> spcific expertise, and research.

>

> *****************************************

> My point was a marketing strategy causes one to behave in a

certain

> way. For example, to change protocols to fit in the western

> community. To use a certificate with no licensing or accreditation

> as a way to differentiate yourself from other licensed

> practitioners. To use a certificate as a way to show one is

> qualified to practice and implying that others who don't have one

> are not. These are examples of side effects of Marketing, I'm not

> judging it, just seeing it on one dimension.

>

>

>

> I also do not equate the deepening of the knowledge of Chinese

> Medicine with a purely backward looking approach - toward classic

> texts and lineage traditions. Rather, I see the future of Chinese

> Medicine and the deepening of our knowledge as being research and

> evidence based.

> ******************************************************

> If you practice it is based on the classics,

there

> is no way around it. I'm suggesting if we don't study the classics

> deeply we only scratch the surface in understanding how to apply

our

> medicine. On one level research and evidence will conform what we

> practice.

>

> If I want to push this its possible many of us realize we only

have

> a very basic and very narrow view of Acupuncture, which can be a

> good thing to motivate us to continuing our study, which

translates

> directly into clinical practice. I could argue about those driving

> research, do they have a deep level of knowledge of our medicine

or

> a very narrow view of it? I had to go throught this, to realize I

> had to go back to the classics and study more and more, these were

> brilliant people, with a holistic view of life and medicine.

>

> Can you share the research models you use, in detail so we can

> analyze the parameters used so we can judge it? And we can see the

> assumptions and possible flaws?

>

>

> I do not accept the " facts " of because a famous

> doctor wrote his data in a book 1,000 years ago. I would like to

see

> (both in principle and in practice) subjected to

> solid scientific research. This is my mission and my passion, and I

> think that one of the best ways to accomplish this is to team up

> with the western medical and scientific community.

> **************************************************

> Teaming up is good. But the research should follow our practice,

to

> follow Chinese medical applications, not some western model of

> acupuncture.

>

> Science doe not yet have the technology to measure how acupuncture

> works, does not have the vehicle to measure how we view the human

> body. Scientific tools must evolve to being able to measure the

> range of what our medicine can do, it can measure some things,

lets

> not be defined by a western medical model. ISN'T this why the

public

> is going to , because they are not so happy with

> Western Medicine for all their healthcare?

>

> If you don't study the classics, which most text books are based

on

> and these authors take the liberty to filter and present their

> understanding and are in many cases very deficient, we never

become

> what I would call an Acupuncturist using most systems of

> Acupuncture, not one ZangFu channel based medicine.

>

> There is much in these classics, if you use Acupuncture you are

> using applications of the Classics, no way to get around it, I'm

> suggesting we need to continue studying more, not for theory, but

> for application.

>

>

> I do not feel animosity toward more classical approaches to Chinese

> Medicine, I think this will always have a place in our culture. But

> I think integration is the future and the fate of integration lies

> in quality evidence-based research.

> ************************************************************

> If one practices Acupuncture, they are using classical Chinese

> Medicine, but maybe on a very simple or superficial or narrow

view.

> It just comes down to the depth we want to practice. In the same

way

> you express many people don't really understand the depths of

> Infertility, I'm suggesting the same for Acupuncture. For me this

is

> not an issue of Research or Evidence, it's a matter of how deep

does

> one want to study and apply this knowledge.

>

> I really don't know how to say this, we only scratch the surface

in

> the study of Acupuncture, it sounds strange saying this in the

year

> 2007, but I have studied a few Taoist arts and its true there too,

> whether it be Feng Shui, Chinese Astrology, Nei Gong and so much

in

> the Nei Jing, for whatever reasons this is true, but it is

changing

> as more people present deeper knowledge of , for

> example, Jeffrey Yuen.

>

>

> Regards,

>

> David

>

[Guest guest]

Hi David, I don't know if we can operate on the same track or not, but let me

give it another swing.

 

Inefficient reproductive system: When we look a big picture, what seems to have

been inefficient at a lower level, suddenly becomes efficient, or in other

words, necessary. It would be a very bad idea for human females to become

impregnated every time they engaged in intercourse. This so-called 100%

efficiency has little or nothing to do with real-world needs.

 

Nonetheless, a failure rate of one-in-four for the natural " non-efficient "

method at a cost of some wining and dining to get her in the mood, is not bad

compared to thousands of dollars. Plus sex can be an intimate, sensual pastime,

whereas IVF is not, obviously.

 

As you say, when there are issues of age, disease or whatever thrown into the

mix, of course the " inefficient " human reproductive system doesn't do such a

good job, and perhaps well it shouldn't. Like I say to my " male problem "

patients, " maybe your body is trying to tell you something " . If our body is

saying stop inthe clearest, most black and white way possible, perhaps it is

actually an incredibly efficient system shouting " warning! warning! " . Maybe it

is our minds and its delusions that are inefficient.

 

This ties into an interesting ethical point. What do we do as healthcare

providers when we are sure that there is a high risk of a baby being born with

too great a deficiency of jing? I had a case like this. I had just gotten to

know the couple so I didn't dare say to them, listen, the husband is too weak

and tired, and the wife is working too hard, plus she is quite yin deficient -

why don't you two put it off for a while and make yourselves stronger? After

all, you are responsible for creating the vehicle which will house your child.

Unfortunately, in this case, the mother had a fairly uncomfortable 9 months, and

the child in question was born with a small deformity on the left hand and a

tendency to abdominal pain at night as well as evident s & s of yin deficiency.

Otherwise healthy. Luckily the parents became very motivated about their second

child and did follow my recommendations. Guess what? The second pregnancy went

off without a hitch, no

nausea, no long labour, the baby was born without any deformations, and I

suppose most relevantly for us, this child had no digestive troubles or pain,

slept better than the first and has no signs of yin-deficiency whatsoever. What

have other list members done?

 

I mean, if you were a mechanic, and the way you " fixed " flat tires was by

installing high-tech air pumps through the axle that fed into the tires and kept

them inflated due to higher internal air pressure, it might work, but some

people might comment " it's a little complicated, and gosh isn't that expensive? "

If you could achieve sales with your system, I am sure it would be lucrative

too. And I'll be darned if in some strange way it doesn't look better than the

sap who just gives you a new tire and asks you not to overinflate...if you get

my meaning.

 

Hugo

 

 

David Karchmer <acuprof

Chinese Medicine

Friday, 7 September, 2007 12:34:39 AM

Re: A case in point

 

 

 

 

 

 

 

 

 

 

 

 

 

Hugo,

 

 

 

One other point I'd like to make since re-reading your last post.

 

 

 

You said, " I am astounded at how people will drop 15 thousand

 

dollars or more on IVF tx with no results, and yet, magically, do

 

not hold the western specialist accountable. It must be some

 

mystical ability of the western sage to " know without knowing " .

 

------------ --------- --------- --------- --------- --------- -

 

The thing about IVF is that it is not 100% effective. In general,

 

human reproduction is a very inefficient system.

 

 

 

If you took 100 healthy 25 year old couples in perfect reproductive

 

health, and all of these 100 couples had unprotected sex during the

 

woman's ovulation, do you know how many would be expected to

 

conceive?

 

 

 

About 20-25 out of the 100 couples. With each attempt, health 25

 

year old couples can expect about a 20-25% chance of conception.

 

Said another way, human reproduction amounts to a 75% failure rate

 

per attempt.

 

 

 

Now, add to the mix age, health problems, hormonal problems,

 

surgeries, etc., and of course, the odds go down.

 

 

 

Assisted reproductive technologies like IVF have MUCH HIGHER rates

 

of success than the old fashioned, " natural approach. " Still, the

 

success rate is not 100%. In fact, it is not even close to that.

 

 

 

But, all infertility clinics are required to report their statistics

 

to the CDC, and most clinics post their success rates on their

 

websites. Furthermore, most (if not all) RE's inform couples of the

 

statistical probabilities of success before any procedures take

 

place. So, the reason (i think) that many people do not hold their

 

physician or IVF clinic responsible for a failed cycle is that

 

failure is a very probable outcome, and this is understood by all

 

parties from the very start.

 

 

 

If a doctor told his or her patients that they had a 99% chance of

 

success, and then the cycle failed...... ...I could see why people

 

would, as you say, " hold the western specialist accountable. " But,

 

that is just not the case, and most people understand the bargain

 

from the get go.

 

 

 

David Karchmer

 

 

 

Traditional_ Chinese_Medicine , Hugo Ramiro

 

<subincor@.. .> wrote:

 

>

 

> Hi David, I followed this thread with interest. I myself do know

 

what PCOS stands for, and I can't for the life of me understand how

 

it betters the treatments I offer in any _significant_ way, or even

 

at all. I don't know how to fit " PCOS " into a Chinese medical

 

differentiation, especially when even the source materials on PCOS

 

admit that " not all cases of PCOS will demonstrate the same

 

symptoms " . Where is the standard?

 

> I also find it interesting that no western infertility specialist

 

would be disqualified because they did not know the Chinese medical

 

terms blood stasis, taxation, or spirit-disposition. Of course we

 

can discuss issues regarding dominant systems and whatnot, but

 

really, logically, there are many cases of infertility where the

 

(western) specialist _should_ be disqualified for their lack of

 

understanding of certain realities of the human body. I am astounded

 

at how people will drop 15 thousand dollars or more on IVF tx with

 

no results, and yet, magically, do not hold the western specialist

 

accountable. It must be some mystical ability of the western sage

 

to " know without knowing " .

 

> It would be interesting for you to note for us how knowing about

 

western medicine's PCOS has helped you define TCM treatments better.

 

Perhaps this might even bring to light deficiencies in your

 

particular skills at using the tools CM provides you with.

 

> All said, however, it is clear that practitioners such as

 

yourself have an important role to play, as do the other

 

practitioners who practice good, solid CM and also know nothing

 

about PCOS.

 

> And of course, this post only highlights my own particular

 

strengths and weaknesses. I certainly do not mean to say that

 

western and eastern will never mix, this is merely a good

 

opportunity for me to raise what I consider to be interesting, and

 

yes, provocative, points.

 

> Thanks for reading,

 

> Hugo

 

>

 

>

 

>

 

>

 

>

 

> David Karchmer <acuprof >

 

>

 

> Thursday, 6 September, 2007 5:41:43 PM

 

> Re: A case in point

 

>

 

>

 

>

 

>

 

>

 

>

 

>

 

>

 

>

 

>

 

>

 

>

 

>

 

> Andrea,

 

>

 

>

 

>

 

> Thanks for clarifying. Please understand that I mean no disrespec,

 

>

 

> and I certainly do not doubt your abilities as an acupuncturist.

 

But

 

>

 

> I use your comments as an illustration to those who argue that

 

every

 

>

 

> acupuncturist is equally qualified to treat and manage Infertility

 

>

 

> cases. EVERY acupuncturist who treats infertility regularly knows

 

>

 

> that acronym.

 

>

 

>

 

>

 

> Again, please pardon me if I singled you out or if my comment was

 

>

 

> crass. I beleive that it furthers the point that I am trying to

 

make

 

>

 

> that there exists a genuine and immediate need to give both

 

doctors

 

>

 

> and the general public a means by which they can assess who

 

>

 

> possesses the specialized knowledge and expertise required to

 

>

 

> effectively treat infertility with hacupuncture and TCM.

 

>

 

>

 

>

 

> David Karchmer

 

>

 

>

 

>

 

> Traditional_ Chinese_Medicine , Andrea

 

Beth

 

>

 

> Damsky <@ .> wrote:

 

>

 

> >

 

>

 

> > David,

 

>

 

> >

 

>

 

> > To clarify, I posted the question, and yes, I am a licensed

 

>

 

> acupuncturist. It is true, I had not previously seen the

 

>

 

> acronym " PCOS " for polycystic ovarian syndrome. Nor have I ever

 

>

 

> treated anyone who had been diagnosed with this condition. I do

 

>

 

> know of the diagnosis, but had not heard the acronym before.

 

While

 

>

 

> I have successfully treated women for a wide variety of

 

>

 

> gynecological issues, I do not do fertility medicine. My

 

expertise

 

>

 

> lies in other areas.

 

>

 

> >

 

>

 

> > , MSTOM, LAc, Dipl OM (NCCAOM)

 

>

 

> >

 

>

 

> > David Karchmer <acuprof@ > wrote: Right on this very discussion

 

>

 

> board, in the middle of this dialogue

 

>

 

> > about ABORM, and who is or is not qualified to treat infertility

 

>

 

> > somebody posted a very simple question, " What is PCOS? "

 

>

 

> >

 

>

 

> > See message #26271.

 

>

 

> >

 

>

 

> > I presume that the person who posted the question is an

 

>

 

> acupuncturist,

 

>

 

> > as most of us on this discussion board are. So I ask you this,

 

is

 

>

 

> this

 

>

 

> > acupuncturist qualified to treat and manage infertility cases??

 

>

 

> >

 

>

 

> > Those of you who argue against specialty certification and claim

 

>

 

> that

 

>

 

> > all acupuncturists are created equal, do you honestly feel that

 

>

 

> > someone who does not know what PCOS is should be treating

 

>

 

> infertility? ?

 

>

 

> >

 

>

 

> > There is absolutely nothing wrong with not knowing that. None of

 

>

 

> us

 

>

 

> > knows everything about every syndrome. But this is precisely why

 

>

 

> > specialization and Board Certification in specialized areas is

 

>

 

> needed

 

>

 

> > and is valuable.

 

>

 

> >

 

>

 

> > David Karchmer

 

>

 

> >

 

>

 

> >

 

>

 

> >

 

>

 

> > Subscribe to the fee online journal for TCM at

 

>

 

> Times http://www.chinesem edicinetimes. com

 

>

 

> >

 

>

 

> > Help build the world's largest online encyclopedia for Chinese

 

>

 

> medicine and acupuncture, click,

 

>

 

> http://www.chinesem edicinetimes. com/wiki/ CMTpedia

 

>

 

> >

 

>

 

> >

 

>

 

> http://groups. / group/Traditiona l_Chinese_ Medicine/

 

join and

 

>

 

> adjust accordingly.

 

>

 

> >

 

>

 

> > Messages are the property of the author. Any duplication outside

 

>

 

> the group requires prior permission from the author.

 

>

 

> >

 

>

 

> > Please consider the environment and only print this message if

 

>

 

> absolutely necessary.

 

>

 

> >

[Guest guest]

To clarify: What have other list members done in this situation? Do you explain

to them, fight them, fire them, or just stay out of the way until there's an

opening?

Hugo

 

 

Hugo Ramiro <subincor

Chinese Medicine

Monday, 10 September, 2007 2:05:33 PM

 

most relevantly for us, this child had no digestive troubles or pain, slept

better than the first and has no signs of yin-deficiency whatsoever. What have

other list members done?

 

 

 

 

 

 

 

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[Guest guest]

Hugo,

 

I hesitate to write back so soon without giving others a chance to

weigh in on some of the things you've suggested, but since I have

just spent the afternoon preparing for the ABORM exam by studying up

on Male Factor Infertility, I feel compelled to respond.

 

First of all, I want to acknowledge you for taking the time to

respond to my earlier posts and continue the dialogue.

 

I hardly know where to begin a response to your last post because it

covered a lot of territory. Let's start with the Efficiency of the

Reproductive System. Yes, I can see that what we describe as an

inefficiency at the Individual/Micro level could be viewed as having

its own economy at the Evolutionary/Macro level.

 

But, my patients who are desperate to become pregnant just couldn't

care less about philosophy. And that is what it is, philosophy - not

medicine. This applies as well to your statements about who " should "

or " should not " get pregnant, whereby you interpret the symptoms of

infertility as the body trying to communicate a message. This is not

medicine, it is philosphy.

 

Of course we are ethically bound to report our findings to the

patient and to warn them about potential or impending health risks.

For example, the diagnosis of Pre-mature Ovarian Failure (POF)

carries with it a many fold increase in the patient's risk for

osteoperosis, diabetes, hypothyroidism, and chromosomal aberrations

such as Fragile X syndrome.

 

However, in the absence of a compelling medical reason, I do not

think that any of us possesses the insight or the knowledge to

assume which of our patients should or should not try to achieve

pregnancy. That is a very personal choice that I believe should rest

entirely with the patient and their spouse. They should bring THEIR

moral and ethical views to bear on that decision; WE should not

impose ours. Otherwise, it is a very slippery slope we embark upon,

trying to dictate who we feel that we " should " or " should not " help

to achieve their goal of conception.

 

Furthermore, ethics aside, without the adequate knowledge and

understanding of reproductive health a practitioner may be poised to

grossly misinterpret the facts of their patient's situation. For

example, you used an example of patient's with " male problem. "

 

I am having to read between the lines here because I do not know of

a diagnosis called, " Male Problem. " But I assume that you mean

either erectile dysfunction, poor sperm count, or a decrease in

either sperm morphology or motility. A deficiency in Kidney Jing is

only one from among several potential differentiations of these

conditions. So, I think it is presumptuous to assume that any of

these necessarily involve the Essence.

 

Let's take the examples of azoospermia and oligospermia. These can

arise from a number of causes such as Yin Deficiency with Heat, Full

Heat, Damp Heat, Blood Stasis, and Qi Stagnation. Furthermore, the

sperm count can be affected by exposure to environmental toxicity.

 

Male factor infertility can also be caused by obstructions such as a

vericocele which may need a surgical intervention to correct.

 

These are just some of the reasons why it is important for

acupuncturists to be knowledgeable about reproductive medicine in

order to handle fertility cases effectively. The kinds of points

raised in your most recent post really serve to highlight the

arguments that I have made, that there is a tangible and clinical

difference between generalists and reproductive specialists, and

that the public should be given an opportunity to understand that

difference.

 

As for your final point, about tire inflation, it seems that you are

insinuating that there is a mercenary motivation behind acupuncture

fertility treatments. I wll tell you Hugo, that if I am interpreting

your metaphor correctly, I resent that sentiment very much. And I am

tired of hearing people on this board make such a callous

assumption, both about the ABORM as an organization and about

individual practitioners who specialize in reproductive medicine.

 

There is just no basis to your claim other than your own cynical

suspicions. All of the acupuncturists that I know who specialize in

reproductive medicine are highly dedicated professionals who are

passionate about what they do. I know that a lot of our colleagues

think that the ABORM is a devisive force for our profession, but I

think that it is much more devisive for each of us to broadcast

negative assumptions about our colleagues motivation, and make such

acusations.

 

David Karchmer

 

Chinese Medicine , Hugo Ramiro

<subincor wrote:

>

> Hi David, I don't know if we can operate on the same track or

not, but let me give it another swing.

>

> Inefficient reproductive system: When we look a big picture, what

seems to have been inefficient at a lower level, suddenly becomes

efficient, or in other words, necessary. It would be a very bad idea

for human females to become impregnated every time they engaged in

intercourse. This so-called 100% efficiency has little or nothing to

do with real-world needs.

>

> Nonetheless, a failure rate of one-in-four for the natural " non-

efficient " method at a cost of some wining and dining to get her in

the mood, is not bad compared to thousands of dollars. Plus sex can

be an intimate, sensual pastime, whereas IVF is not, obviously.

>

> As you say, when there are issues of age, disease or whatever

thrown into the mix, of course the " inefficient " human reproductive

system doesn't do such a good job, and perhaps well it shouldn't.

Like I say to my " male problem " patients, " maybe your body is trying

to tell you something " . If our body is saying stop inthe clearest,

most black and white way possible, perhaps it is actually an

incredibly efficient system shouting " warning! warning! " . Maybe it

is our minds and its delusions that are inefficient.

>

> This ties into an interesting ethical point. What do we do as

healthcare providers when we are sure that there is a high risk of a

baby being born with too great a deficiency of jing? I had a case

like this. I had just gotten to know the couple so I didn't dare say

to them, listen, the husband is too weak and tired, and the wife is

working too hard, plus she is quite yin deficient - why don't you

two put it off for a while and make yourselves stronger? After all,

you are responsible for creating the vehicle which will house your

child. Unfortunately, in this case, the mother had a fairly

uncomfortable 9 months, and the child in question was born with a

small deformity on the left hand and a tendency to abdominal pain at

night as well as evident s & s of yin deficiency. Otherwise healthy.

Luckily the parents became very motivated about their second child

and did follow my recommendations. Guess what? The second pregnancy

went off without a hitch, no

> nausea, no long labour, the baby was born without any

deformations, and I suppose most relevantly for us, this child had

no digestive troubles or pain, slept better than the first and has

no signs of yin-deficiency whatsoever. What have other list members

done?

>

> I mean, if you were a mechanic, and the way you " fixed " flat

tires was by installing high-tech air pumps through the axle that

fed into the tires and kept them inflated due to higher internal air

pressure, it might work, but some people might comment " it's a

little complicated, and gosh isn't that expensive? " If you could

achieve sales with your system, I am sure it would be lucrative too.

And I'll be darned if in some strange way it doesn't look better

than the sap who just gives you a new tire and asks you not to

overinflate...if you get my meaning.

>

> Hugo

>

>

> David Karchmer <acuprof

> Chinese Medicine

> Friday, 7 September, 2007 12:34:39 AM

> Re: A case in point

>

>

>

>

>

>

>

Hugo,

>

>

>

> One other point I'd like to make since re-reading your last post.

>

>

>

> You said, " I am astounded at how people will drop 15 thousand

>

> dollars or more on IVF tx with no results, and yet, magically, do

>

> not hold the western specialist accountable. It must be some

>

> mystical ability of the western sage to " know without knowing " .

>

> ------------ --------- --------- --------- --------- --------- -

>

> The thing about IVF is that it is not 100% effective. In general,

>

> human reproduction is a very inefficient system.

>

>

>

> If you took 100 healthy 25 year old couples in perfect

reproductive

>

> health, and all of these 100 couples had unprotected sex during

the

>

> woman's ovulation, do you know how many would be expected to

>

> conceive?

>

>

>

> About 20-25 out of the 100 couples. With each attempt, health 25

>

> year old couples can expect about a 20-25% chance of conception.

>

> Said another way, human reproduction amounts to a 75% failure rate

>

> per attempt.

>

>

>

> Now, add to the mix age, health problems, hormonal problems,

>

> surgeries, etc., and of course, the odds go down.

>

>

>

> Assisted reproductive technologies like IVF have MUCH HIGHER rates

>

> of success than the old fashioned, " natural approach. " Still, the

>

> success rate is not 100%. In fact, it is not even close to that.

>

>

>

> But, all infertility clinics are required to report their

statistics

>

> to the CDC, and most clinics post their success rates on their

>

> websites. Furthermore, most (if not all) RE's inform couples of

the

>

> statistical probabilities of success before any procedures take

>

> place. So, the reason (i think) that many people do not hold their

>

> physician or IVF clinic responsible for a failed cycle is that

>

> failure is a very probable outcome, and this is understood by all

>

> parties from the very start.

>

>

>

> If a doctor told his or her patients that they had a 99% chance of

>

> success, and then the cycle failed...... ...I could see why people

>

> would, as you say, " hold the western specialist accountable. "

But,

>

> that is just not the case, and most people understand the bargain

>

> from the get go.

>

>

>

> David Karchmer

>

>

>

> Traditional_ Chinese_Medicine , Hugo

Ramiro

>

> <subincor@ .> wrote:

>

> >

>

> > Hi David, I followed this thread with interest. I myself do

know

>

> what PCOS stands for, and I can't for the life of me understand

how

>

> it betters the treatments I offer in any _significant_ way, or

even

>

> at all. I don't know how to fit " PCOS " into a Chinese medical

>

> differentiation, especially when even the source materials on PCOS

>

> admit that " not all cases of PCOS will demonstrate the same

>

> symptoms " . Where is the standard?

>

> > I also find it interesting that no western infertility

specialist

>

> would be disqualified because they did not know the Chinese

medical

>

> terms blood stasis, taxation, or spirit-disposition. Of course we

>

> can discuss issues regarding dominant systems and whatnot, but

>

> really, logically, there are many cases of infertility where the

>

> (western) specialist _should_ be disqualified for their lack of

>

> understanding of certain realities of the human body. I am

astounded

>

> at how people will drop 15 thousand dollars or more on IVF tx with

>

> no results, and yet, magically, do not hold the western specialist

>

> accountable. It must be some mystical ability of the western sage

>

> to " know without knowing " .

>

> > It would be interesting for you to note for us how knowing

about

>

> western medicine's PCOS has helped you define TCM treatments

better.

>

> Perhaps this might even bring to light deficiencies in your

>

> particular skills at using the tools CM provides you with.

>

> > All said, however, it is clear that practitioners such as

>

> yourself have an important role to play, as do the other

>

> practitioners who practice good, solid CM and also know nothing

>

> about PCOS.

>

> > And of course, this post only highlights my own particular

>

> strengths and weaknesses. I certainly do not mean to say that

>

> western and eastern will never mix, this is merely a good

>

> opportunity for me to raise what I consider to be interesting, and

>

> yes, provocative, points.

>

> > Thanks for reading,

>

> > Hugo

>

> >

>

> >

>

> >

>

> >

>

> >

>

> > David Karchmer <acuprof@ >

>

> >

>

> > Thursday, 6 September, 2007 5:41:43 PM

>

> > Re: A case in point

>

> >

>

> >

>

> >

>

> >

>

> >

>

> >

>

> >

>

> >

>

> >

>

> >

>

> >

>

> >

>

> >

>

> > Andrea,

>

> >

>

> >

>

> >

>

> > Thanks for clarifying. Please understand that I mean no

disrespec,

>

> >

>

> > and I certainly do not doubt your abilities as an acupuncturist.

>

> But

>

> >

>

> > I use your comments as an illustration to those who argue that

>

> every

>

> >

>

> > acupuncturist is equally qualified to treat and manage

Infertility

>

> >

>

> > cases. EVERY acupuncturist who treats infertility regularly

knows

>

> >

>

> > that acronym.

>

> >

>

> >

>

> >

>

> > Again, please pardon me if I singled you out or if my comment

was

>

> >

>

> > crass. I beleive that it furthers the point that I am trying to

>

> make

>

> >

>

> > that there exists a genuine and immediate need to give both

>

> doctors

>

> >

>

> > and the general public a means by which they can assess who

>

> >

>

> > possesses the specialized knowledge and expertise required to

>

> >

>

> > effectively treat infertility with hacupuncture and TCM.

>

> >

>

> >

>

> >

>

> > David Karchmer

>

> >

>

> >

>

> >

>

> > Traditional_ Chinese_Medicine , Andrea

>

> Beth

>

> >

>

> > Damsky <@ .> wrote:

>

> >

>

> > >

>

> >

>

> > > David,

>

> >

>

> > >

>

> >

>

> > > To clarify, I posted the question, and yes, I am a licensed

>

> >

>

> > acupuncturist. It is true, I had not previously seen the

>

> >

>

> > acronym " PCOS " for polycystic ovarian syndrome. Nor have I ever

>

> >

>

> > treated anyone who had been diagnosed with this condition. I do

>

> >

>

> > know of the diagnosis, but had not heard the acronym before.

>

> While

>

> >

>

> > I have successfully treated women for a wide variety of

>

> >

>

> > gynecological issues, I do not do fertility medicine. My

>

> expertise

>

> >

>

> > lies in other areas.

>

> >

>

> > >

>

> >

>

> > > , MSTOM, LAc, Dipl OM (NCCAOM)

>

> >

>

> > >

>

> >

>

> > > David Karchmer <acuprof@ > wrote: Right on this very

discussion

>

> >

>

> > board, in the middle of this dialogue

>

> >

>

> > > about ABORM, and who is or is not qualified to treat

infertility

>

> >

>

> > > somebody posted a very simple question, " What is PCOS? "

>

> >

>

> > >

>

> >

>

> > > See message #26271.

>

> >

>

> > >

>

> >

>

> > > I presume that the person who posted the question is an

>

> >

>

> > acupuncturist,

>

> >

>

> > > as most of us on this discussion board are. So I ask you this,

>

> is

>

> >

>

> > this

>

> >

>

> > > acupuncturist qualified to treat and manage infertility cases??

>

> >

>

> > >

>

> >

>

> > > Those of you who argue against specialty certification and

claim

>

> >

>

> > that

>

> >

>

> > > all acupuncturists are created equal, do you honestly feel

that

>

> >

>

> > > someone who does not know what PCOS is should be treating

>

> >

>

> > infertility? ?

>

> >

>

> > >

>

> >

>

> > > There is absolutely nothing wrong with not knowing that. None

of

>

> >

>

> > us

>

> >

>

> > > knows everything about every syndrome. But this is precisely

why

>

> >

>

> > > specialization and Board Certification in specialized areas is

>

> >

>

> > needed

>

> >

>

> > > and is valuable.

>

> >

>

> > >

>

> >

>

> > > David Karchmer

>

> >

>

> > >

>

> >

>

> > >

>

> >

>

> > >

>

> >

>

> > > Subscribe to the fee online journal for TCM at Chinese

Medicine

>

> >

>

> > Times http://www.chinesem edicinetimes. com

>

> >

>

> > >

>

> >

>

> > > Help build the world's largest online encyclopedia for Chinese

>

> >

>

> > medicine and acupuncture, click,

>

> >

>

> > http://www.chinesem edicinetimes. com/wiki/ CMTpedia

>

> >

>

> > >

>

> >

>

> > >

>

> >

>

> > http://groups. / group/Traditiona l_Chinese_ Medicine/

>

> join and

>

> >

>

> > adjust accordingly.

>

> >

>

> > >

>

> >

>

> > > Messages are the property of the author. Any duplication

outside

>

> >

>

> > the group requires prior permission from the author.

>

> >

>

> > >

>

> >

>

> > > Please consider the environment and only print this message if

>

> >

>

> > absolutely necessary.

>

> >

>

> > >

[Guest guest]

David,

I've stayed out of this discussion, like Hugo, because of lack of

time, but just as you found some of Hugo's statements offensive, I

find what you've said below to be 'out of line' in terms of Chinese

medical ethics.

 

Of course what Hugo is saying is philosophy. Like it or not,

Chinese medicine is based on philosophy, a philosophy of life. What

I read into what Hugo is saying is that there are ethical concerns

when, for example, a 55 year old woman wants to take fertility drugs

and bear a child which may put her at risk in other aspects of her

health. I, personally, would not choose to treat such a patient, and

would refer her to someone else. In a fertility clinic setting, who

would make that decision? And is the patient informed enough to make

the decision on his or her own?

 

This doesn't mean that Chinese medicine should be 'against' IVF

or other artificial methods of fertility enhancement. It simply

means that Chinese medicine adds another dimension to the subject

that must not be ignored. Every case has its specifics, and we have

to take each case on its merits.

 

By stating what you do about philosophy, it indicates to me that

you are ignoring a very important foundation of Chinese medicine. I

don't know about your patients, but mine do want to know the risks,

the tradeoffs, and the philosophy of Chinese medicine on this issue

and other medical issues as well.

 

 

 

 

On Sep 10, 2007, at 3:28 PM, David Karchmer wrote:

 

>

> But, my patients who are desperate to become pregnant just couldn't

> care less about philosophy. And that is what it is, philosophy - not

> medicine. This applies as well to your statements about who " should "

> or " should not " get pregnant, whereby you interpret the symptoms of

> infertility as the body trying to communicate a message. This is not

> medicine, it is philosphy.

>

>

> However, in the absence of a compelling medical reason, I do not

> think that any of us possesses the insight or the knowledge to

> assume which of our patients should or should not try to achieve

> pregnancy. That is a very personal choice that I believe should rest

> entirely with the patient and their spouse. They should bring THEIR

> moral and ethical views to bear on that decision; WE should not

> impose ours. Otherwise, it is a very slippery slope we embark upon,

> trying to dictate who we feel that we " should " or " should not " help

> to achieve their goal of conception.

 

 

Chair, Department of Herbal Medicine

Pacific College of Oriental Medicine

San Diego, Ca. 92122

 

 

 

 

 

 

 

[Guest guest]

Now hold up there Z'ev,

 

You are taking my comments completely out of context.

 

In response to my generalized comments about the inherent

inefficiencies of the human reproduction system Hugo stated:

 

" When we look a big picture, what seems to have been inefficient at

a lower level, suddenly becomes efficient, or in other words,

necessary. It would be a very bad idea for human females to become

impregnated every time they engaged in intercourse. This so-called

100% efficiency has little or nothing to do with real-world needs.

Nonetheless, a failure rate of one-in-four for the natural " non-

efficient " method at a cost of some wining and dining to get her in

the mood, is not bad compared to thousands of dollars. Plus sex can

be an intimate, sensual pastime, whereas IVF is not, obviously. "

 

It took me a few reads to decipher this statement, but I am pretty

sure that what he is saying amounts to this: Human reproduction may

be inefficient at the micro/individual level, but this reality

serves a purpose at the macro/evolutionary level. In other words, it

is good that we are inefficient as individuals; otherwise herd

population would exert untenable pressures on resources.

 

THIS is the philosophy to which I was referring, not TCM or Taoist

philosophy.

 

The view that it is better for humans to have inefficient

reproductive systems so that our population stays under control is

the 'philosophy' that I am saying my patients do not care about.

 

Of course I am for providing patients prudent medical advice to help

advise them about the risks associated with various procedures, both

western and eastern.

 

I said " in the absence of a compelling medical reason, I do not

think that any of us possesses the insight or the knowledge to

assume which of our patients should or should not try to achieve

pregnancy. "

 

I would consider a severe Jing or Yin deficiency a compelling

medical reason. And for patients who have these types of problems,

we advise a waiting period of 3-9 months (depending on history etc.)

before trying to get pregnant or undergo ART procedures.

 

I also said the following, which for some reason you deleted in your

response:

 

“Of course we are ethically bound to report our findings to the

patient and to warn them about potential or impending health risks.

For example, the diagnosis of Pre-mature Ovarian Failure (POF)

carries with it a many fold increase in the patient's risk for

osteoporosis, diabetes, hypothyroidism, and chromosomal aberrations

such as Fragile X syndrome.â€

 

David Karchmer

 

Chinese Medicine , " Z'ev

Rosenberg " <zrosenbe wrote:

>

> David,

> I've stayed out of this discussion, like Hugo, because of lack

of

> time, but just as you found some of Hugo's statements offensive,

I

> find what you've said below to be 'out of line' in terms of

Chinese

> medical ethics.

>

> Of course what Hugo is saying is philosophy. Like it or

not,

> Chinese medicine is based on philosophy, a philosophy of life.

What

> I read into what Hugo is saying is that there are ethical

concerns

> when, for example, a 55 year old woman wants to take fertility

drugs

> and bear a child which may put her at risk in other aspects of

her

> health. I, personally, would not choose to treat such a patient,

and

> would refer her to someone else. In a fertility clinic setting,

who

> would make that decision? And is the patient informed enough to

make

> the decision on his or her own?

>

> This doesn't mean that Chinese medicine should be 'against'

IVF

> or other artificial methods of fertility enhancement. It simply

> means that Chinese medicine adds another dimension to the subject

> that must not be ignored. Every case has its specifics, and we

have

> to take each case on its merits.

>

> By stating what you do about philosophy, it indicates to me

that

> you are ignoring a very important foundation of Chinese medicine.

I

> don't know about your patients, but mine do want to know the

risks,

> the tradeoffs, and the philosophy of Chinese medicine on this

issue

> and other medical issues as well.

>

>

>

>

> On Sep 10, 2007, at 3:28 PM, David Karchmer wrote:

>

> >

> > But, my patients who are desperate to become pregnant just

couldn't

> > care less about philosophy. And that is what it is, philosophy -

not

> > medicine. This applies as well to your statements about

who " should "

> > or " should not " get pregnant, whereby you interpret the symptoms

of

> > infertility as the body trying to communicate a message. This is

not

> > medicine, it is philosphy.

> >

> >

> > However, in the absence of a compelling medical reason, I do not

> > think that any of us possesses the insight or the knowledge to

> > assume which of our patients should or should not try to achieve

> > pregnancy. That is a very personal choice that I believe should

rest

> > entirely with the patient and their spouse. They should bring

THEIR

> > moral and ethical views to bear on that decision; WE should not

> > impose ours. Otherwise, it is a very slippery slope we embark

upon,

> > trying to dictate who we feel that we " should " or " should not "

help

> > to achieve their goal of conception.

>

>

> Chair, Department of Herbal Medicine

> Pacific College of Oriental Medicine

> San Diego, Ca. 92122

 

[Guest guest]

Hugo,

 

I too would like to keep this thread relevant and useful. But I don't

think that you are responsible or intellectually honest in the way

that you are going about it. On the one hand, you have made some

pretty outrageous allegations about practitioner financial motivation

and on the other hand, you want people to " take it easy " and keep the

tone " fun " in their responses.

 

Are you being serious about your views on specialization, specialty

boards, practitioner competence (or lack thereof) and your suspicions

about financial motivation? Or are you just whimsically exploring a

few ideas about the subject(s)?

 

I think that I have made it pretty clear that I am serious about this

stuff. I realize that my views may not necessarily be in step with the

mainstream, and that I have invited opposition by choosing to be

vocal. But I am absolutely earnest about the importance of the topic.

So, please - enough already with telling me to take it easy, keep it

fun, and that I just need to drop it.

 

Thanks,

 

David Karchmer

 

 

 

 

Chinese Medicine , Hugo Ramiro

<subincor wrote:

>

> David, David, take it easy! This has been a fun conversation once

we got it back on track. Worthwhile I think. There are a lot of very

important issues that have been brought up, and that's what this forum

is about. So thank you for your time. Let's keep at it as long as it

is useful!

> Write ya later,

> Hugo

>

>

[Guest guest]

Well David, tit for tat again I suppose. It's a little boring. I make a

comment about mechanics and technological fixes and you think I shouldn't do

that, and are offended(?), and yet you feel free to hit back with charges of

intellectual dishonesty and irresponsibility (those are pretty serious, ya

know). Have your cake and eat it too? I don't think so, at least not with me.

So anyway, if we're done with the alpha-male thing, let's move on.

 

We have seen and documented, over and over, the human activities of corruption,

power-mongering, etc etc. As a profession, we have seen supposed " scientists "

dismiss reasoning, data, and evidence a priori, repeatedly. Some wiring is on

the fritz there. I insist that intellectual bias as well as financial

motivation are a huge factor in any organisation, and need to be dealt with

ethically, as much as is possible. I have no particular concerns with ABORM over

other organisations. I have a particular concern with reproductive technologies

(which are a part of the overall medical organisation, to be clear). The ethical

question I brought up with the mechanic analogy is the following: if you can do

something cheaply, why do it expensively? Further, if there is no evidence to

support the use of an expensive, invasive procedure over the use of a cheaper,

non-invasive procedure, then what should one do? Further, what is the long-term

evidence supporting the

use of reproductive technologies? Where are the studies describing the misuse

of reproductive technologies?

Is that clear enough for you? As a side-note, these are not jabs at you, these

are simply restatements of what every single post of mine has been about. I'd

also like to ask, where is the evidence that supports your point of view that we

need certification? That specialist certification improves patient care and

outcome? I am concerned that the CM profession is simply apeing western medical

procedures and curricula. Don't even get me started on book learning as

currently taught in many medical schools.

In any case, there is a great deal of controversy on whether to move forward or

study more regarding reproductive technologies, but it might be interesting to

look at ICSI (I don't care if nobody knows what that means, honestly) and how

reproductive scientists feel about it:

 

" No hard evidence presented at the moment can prove or disapprove ICSI's

implications in epigenetic control. Nevertheless, we take the view that more

comprehensive, long-term, and properly designed studies are imperative to be

applied on a large-scale basis. We urge cautiousness, since the welfare of our

progeny is what is at stake. "

 

This is the ethical problem I've posed several times: " Our progeny are at

stake " .

 

Hugo

 

ps - the writers are Greek, forgive their English spelling and grammar. Can be

found at:

http://tinyurl.com/ypc66c

 

 

 

David Karchmer <acuprof

Chinese Medicine

Tuesday, 11 September, 2007 9:21:03 AM

Re: A case in point

 

 

 

 

 

 

 

 

 

 

 

 

 

Hugo,

 

 

 

I too would like to keep this thread relevant and useful. But I don't

 

think that you are responsible or intellectually honest in the way

 

that you are going about it. On the one hand, you have made some

 

pretty outrageous allegations about practitioner financial motivation

 

and on the other hand, you want people to " take it easy " and keep the

 

tone " fun " in their responses.

 

 

 

Are you being serious about your views on specialization, specialty

 

boards, practitioner competence (or lack thereof) and your suspicions

 

about financial motivation? Or are you just whimsically exploring a

 

few ideas about the subject(s)?

 

 

 

I think that I have made it pretty clear that I am serious about this

 

stuff. I realize that my views may not necessarily be in step with the

 

mainstream, and that I have invited opposition by choosing to be

 

vocal. But I am absolutely earnest about the importance of the topic.

 

So, please - enough already with telling me to take it easy, keep it

 

fun, and that I just need to drop it.

 

 

 

Thanks,

 

 

 

David Karchmer

 

 

 

Traditional_ Chinese_Medicine , Hugo Ramiro

 

<subincor@.. .> wrote:

 

>

 

> David, David, take it easy! This has been a fun conversation once

 

we got it back on track. Worthwhile I think. There are a lot of very

 

important issues that have been brought up, and that's what this forum

 

is about. So thank you for your time. Let's keep at it as long as it

 

is useful!

 

> Write ya later,

 

> Hugo

 

>

 

>

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Want ideas for reducing your carbon footprint? Visit For Good

http://uk.promotions./forgood/environment.html

 

 

[Guest guest]

Hugo,

 

I will try to address what I view as the substance of you post.

 

You said, " I have a particular concern with reproductive

technologies (which are a part of the overall medical organisation,

to be clear). The ethical question I brought up with the mechanic

analogy is the following: if you can do something cheaply, why do it

expensively? "

 

First of all, IVF is expensive to administer in part because it

takes very expensive technology to perform. A proper IVF facility

can expect a start up cost of between $1-2 million.

 

Expensive is not synonymous with deceitful or dishonest.

 

Clearly IVF is an expensive treatment. Add ICSI to the mix and it is

more costly. But, as for who should or should not choose the more

expensive treatment, that is a matter of medical necessity and

personal choice.

 

Why should we rule out ART on the basis that it is costly?

 

You said, " I have a particular concern with reproductive

technologies (which are a part of the overall medical organisation,

to be clear). The ethical question I brought up with the mechanic

analogy is the following: if you can do something cheaply, why do it

expensively? "

 

Am I reading you correctly? Are you suggesting that there is

something underhanded, or malevolant about ART?

 

You also said, " Further, if there is no evidence to support the use

of an expensive, invasive procedure over the use of a cheaper, non-

invasive procedure, then what should one do? Further, what is the

long-term evidence supporting the use of reproductive technologies?

Where are the studies describing the misuse of reproductive

technologies? "

 

Just what do you mean by the " evidence supporting ART " or

the " Misuse of ART? "

 

IVF began as a way to help couples where the female partner had no

functional falopian tubes. It is a way to achieve conception and

carry a baby to term by bypassing missing or damaged tubes.

 

Furthermore, if the male has no sperm in the ejaculate, sperm can be

obtained by aspirating it through the epididymous or obtained from

testicular tissue via testicular biopsy. At this point, the sperm

obtained can be used to fertilize the egg by way of ICSI.

 

Are you suggesting that a cheaper method (such as TCM) could be used

instead of IVF in cases of absent oviducts or azoospermia??

 

Really Hugo, I don't think I understand what point you are trying to

make. It just sounds like some kind of Alternative Medicine

conspiracy theory.

 

Can you clarify?

 

David Karchmer

 

Chinese Medicine , Hugo Ramiro

<subincor wrote:

>

> Well David, tit for tat again I suppose. It's a little boring. I

make a comment about mechanics and technological fixes and you think

I shouldn't do that, and are offended(?), and yet you feel free to

hit back with charges of intellectual dishonesty and

irresponsibility (those are pretty serious, ya know). Have your cake

and eat it too? I don't think so, at least not with me.

> So anyway, if we're done with the alpha-male thing, let's move on.

>

> We have seen and documented, over and over, the human activities

of corruption, power-mongering, etc etc. As a profession, we have

seen supposed " scientists " dismiss reasoning, data, and evidence a

priori, repeatedly. Some wiring is on the fritz there. I insist

that intellectual bias as well as financial motivation are a huge

factor in any organisation, and need to be dealt with ethically, as

much as is possible. I have no particular concerns with ABORM over

other organisations. ?I have a particular concern with reproductive

technologies (which are a part of the overall medical organisation,

to be clear). The ethical question I brought up with the mechanic

analogy is the following: if you can do something cheaply, why do it

expensively? Further, if there is no evidence to support the use of

an expensive, invasive procedure over the use of a cheaper, non-

invasive procedure, then what should one do? Further, what is the

long-term evidence supporting the

> use of reproductive technologies? Where are the studies

describing the misuse of reproductive technologies

> Is that clear enough for you? As a side-note, these are not jabs

at you, these are simply restatements of what every single post of

mine has been about. I'd also like to ask, where is the evidence

that supports your point of view that we need certification? That

specialist certification improves patient care and outcome? I am

concerned that the CM profession is simply apeing western medical

procedures and curricula. Don't even get me started on book learning

as currently taught in many medical schools.

> In any case, there is a great deal of controversy on whether to

move forward or study more regarding reproductive technologies, but

it might be interesting to look at ICSI (I don't care if nobody

knows what that means, honestly) and how reproductive scientists

feel about it:

>

> " No hard evidence presented at the moment can prove or disapprove

ICSI's implications in epigenetic control. Nevertheless, we take the

view that more comprehensive, long-term, and properly designed

studies are imperative to be applied on a large-scale basis. We urge

cautiousness, since the welfare of our progeny is what is at stake. "

>

> This is the ethical problem I've posed several times: " Our

progeny are at stake " .

>

> Hugo

>

> ps - the writers are Greek, forgive their English spelling and

grammar. Can be found at:

> http://tinyurl.com/ypc66c

>

[Guest guest]

Hugo,

 

Sorry, I quoted you twice. rushed editing job.

 

DK