DAOM programs

[Guest guest]

David,

 

I am still waiting to hear back from Samra re their DAOM, which they promised

originally would be a non-Friday evening, non-Saturday program, as far as their

second cohort is concerned. What do you know about Yo San's DAOM? When will it

be starting? Have they received accreditation? Anything about days?

 

Thanks,

 

Yehuda

 

David Karchmer <acuprof wrote:

Mike,

 

As far as the DAOM route is concerned, I believe Yosan University in

LA is starting a doctoral program with a singular focus in

Reproductive OM.

 

In terms of creating a healthier society, while I agree that a

healthier society would great, and I recognize that it is a noble

thing to strive toward, this seems to me to be more of a

philosophical issue than a medical one.

 

I know Z'ev already took me to task for promoting the idea of

Chinese " medicine " that is devoid of Taoist philosophy. I do not

advocate that everybody should share my position on this point, but

to try to institute a total transformation of society by application

of TCM is not my personal mission.

 

Furthermore, even if we were to accept that as our premise that it

is our duty as doctors of TCM to improve society, I could argue with

just as much validity that trying to help older, better educated,

wealthy people to reproduce would be hugely advantageous to society.

 

The infertility market is largely characterized by intelligent,

affluent, educated people who are eager to have children, and

therefore would likely be predsiposed to provide their offspring

with an advantaged, loving and nurturing environment.

 

If our goal is to improve society, wouldn't it be helpful to try to

ensure that this segment of society is able to reproduce? And

furthermore, wouldn't it be helpful to try to limit or prevent

reproduction among poor, uneducated, single parents?

 

You raised a concern about environmental issues: wouldn't the

offspring of affluent, educated (but infertile) parents be more

likely to contribute to the solution than would the offspring of

poor, uneducated, single parents?

 

I know that this prospect probably sounds absurd and even facist,

and that such an idea poses and ethical nightmare.

 

But, this is the territory we enter when we start speculating about

the ethics of reproductive medicine. Who should decide who does and

does not get to reproduce? And what are the broader social

implications?

 

I am not a medical ethicist. I am mostly concerned with the health

and the health goals of my patients. And if I am in possession of

some knowledge and some tools to help them to get what they want out

of life, I just try to help them.

 

I know some OB/GYN's who refuse to administer an IUI to a woman who

is not married. If she is gay or single they refuse to perform the

procedure. Personally, I feel like this is discriminatory and that

it is not the role of the doctor to determine who should and should

not receive medical care based on the doctor's personal religious or

moral orientation. In the Bush Administration's FDA there are some

advocates who want to give pharmacists the right to refuse to fill

prescriptions based on the pharmacist's moral judgements. If such

legislation wer to be enacted s/he could legally refuse to fill a

prescription for Birth Control, for example, if the pharmacist were

a Catholic. In both of these cases, there is absolutely no medical

or health basis for the decision to refuse such patients service,

only social or moral reasons.

 

This is my point, Mike. I do not feel that it is my place to try to

use to impose my personal philosophy. Rather it is

my goal to use the medicine that I know to try to help people and to

improve their lives.

 

David Karchmer

 

Chinese Medicine , mike Bowser

<naturaldoc1 wrote:

>

> David,

> After reading many of these posts, it seems to me that the concern

is whether we

> are treating a patient or a pregnancy. It does almost seem to be

a blind interest

> to get people pregnant although I am sure that is not the only

reason for treatment.

>

> Creating a niche simply because people want it is not always a

good thing. We

> need a healthier society and need to get more involved with

environmental issues

> as it will do more to guarantee a future then getting a few people

pregnant.

>

> That is one of many reasons why I do not support a singular focus

organizational

> certification. I can only hope that one of the DAOM's includes a

focus upon fertility

> as it makes a lot more sense to go the formal education route.

Mike W. Bowser, L Ac

>

>

> : acuprof: Wed, 12 Sep

2007 04:23:41 +0000Re: A case in point

>

>

>

>

> Hugo,I am trying to understand you. I find your writing style to

be a bit cryptic, so it's sometimes challenging to decipher what you

are trying to communicate. Even though I am really making an effort,

and checking in by asking such things as, " am I reading you

correctly? " you seem kind of annoyed, and accuse me of " reading into

your posts, but not reading them. " You write in a lot of metaphors,

so there is a need to try to interpret what you are ttempting to

communicate. I apologize if I am not interpreting correctly, but I

am trying.Where IVF is concerned, it seems like you are saying that

it is unethical when there are less expensive alternatives that are

every bit as effective. You say that it would be preferable to

use " a non-invasive procedure [instead of] an invasive procedure if

the results are similar. " You said " I am claiming that you have no

evidence to back up your assertion that ART is the primary choice in

cases of infertility. I'm just looking for the

evidence. " ***********************************************************

****I gave you two clinical scenarios in my last post, neither of

which you have addressed here, and both of which are highly unlikely

to respond to TCM.To quote my last post: " IVF began as a way to help

couples where the female partner had no functional fallopian tubes.

It is a way to achieve conception and carry a baby to term by

bypassing the 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. " So, I'll ask you again: Are you

suggesting that a cheaper method (such as TCM) could be used instead

of IVF in cases of absent oviducts or azoospermia?In your reply to

this post, why didn't you address these very real and very common

clinical situations?I cases of obstructed, scarred or absent

fallopian tubes, do you think that a less expensive therapy (like

TCM) would be as effective as IVF?In the case of azoospermia, or

severely compromised sperm morphology, do you think that a less

expensive therapy (like TCM) would be as effective as IVF?Next Hugo,

you went on to say " I am surprised that you are not aware of the

protocols necessary to evaluate safety and efficacy. " This is not an

answer to my question. I asked, " Just what do you mean by

the " evidence supporting ART " or the " Misuse of ART? " First of all,

to say that you are " surprised " that I don't already know what the

heck you are talking about is not an answer at all. And secondly, I

am asking " what do YOU mean, " because as I already said, I am trying

to check in with you to make sure that we are communicating.Instead

of clarifying your statements, you just ducked the question entirely

by saying, " Just what it says. The medical standard, apparently, is

to find evidence of safety and efficacy. I really don't know what

you're confused about. " Misuse " means " improper, unlawful or

incorrect use " . Understand now? " No Hugo. No, I don't. Are you saying

that IVF is improper, unlawful or performed incorrectly?Are you

saying that this procedure is unsafe? And if so, are you suggesting

that we should refuse to help people who have chosen to do IVF, or

that we should try to persuade them not to do it?When I said, " It

just sounds like some kind of Alternative Medicine conspiracy

theory, " you answered: " You certainly are imaginative. " But that is

just what this sounds like to me. It seems like a witch hunt to

discredit the lawfulness, propriety, or correct usage of IVF. I'm

sorry, but I just do not understand upon what basis you are making

such claims. Furthermore, when I provided specific instances in

which IVF may be absolutely necessary in order to bear biological

children, you declined to comment. You asked for specifics, I gave

you specific. So why no comment? This is a vitally important

conversation to me because I am an advocate for Reproductive

Oriental Medicine as a recognized sub-specialty, and an advocate for

a credentialing process like the one proposed by the ABORM. And

honest to goodness, I am trying to understand your meaning Hugo, but

if you are saying the kinds of things that I think you are, this is

a perfect example of why the public needs a clear distinction made

between those Acupuncturists who understand the science and

procedures involved in reproductive medicine and general

practitioners who dabble in infertility treatment. If I have

misinterpreted your statements, please set the record straight. And

as a request, I would like more data, and fewer metaphors and

inflammatory comments so that we can try, as you suggested to

improve communication between us. David Karchmer

*******************************************************************Me

again.> Here are some quick comments:> > " 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. " > > Yes, David. Obviously.> I did not

state that expensive = deceitful. I stated that expensive + no

evidence to prefer over less expensive = something unethical. I hope

that is clearer, I don't know if I could change that into numbers.>

> " Why should we rule out ART on the basis that it is costly? " > >

Again, that would be on the same grounds that we would prefer a non-

invasive procedure to an invasive procedure if the results are

similar. Where are the studies that compare and contrast CM vs ART?

I don't claim that CM is better, I really don't care about that, I

am claiming that you have no evidence to back up your assertion that

ART is the primary choice in cases of infertility. I'm just looking

for the evidence. It's expected of , so I am

*fairly* expecting it of this particular western modality. This very

point was made by an enlightened presenter at the Grand Rounds at

which I was present last week.> > " Am I reading you correctly? Are

you suggesting that there is> something underhanded, or malevolant

about ART? " > > No, you are not reading correctly.> > I am surprised

that you are not aware of the protocols necessary to evaluate safety

and efficacy.> > " Just what do you mean by the " evidence supporting

ART " or> the " Misuse of ART? " " > > Just what it says. The medical

standard, apparently, is to find evidence of safety and efficacy. I

really don't know what you're confused about. " Misuse "

means " improper, unlawful or incorrect use " . ? Understand now?>

> " It just sounds like some kind of Alternative Medicine> conspiracy

theory. " > > You certainly are imaginative. > > Hugo> > > >

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[Guest guest]

Yehuda,

 

I don't know any details, only that it is starting. I guess you

could contact Yosan or look at their website for more info.

 

David K

 

 

Chinese Medicine , yehuda

frischman < wrote:

>

> David,

>

> I am still waiting to hear back from Samra re their DAOM, which

they promised originally would be a non-Friday evening, non-Saturday

program, as far as their second cohort is concerned. What do you

know about Yo San's DAOM? When will it be starting? Have they

received accreditation? Anything about days?

>

> Thanks,

>

> Yehuda