endocarditis etc See as CONSULT

[Guest guest]

For anyone who aspires to integrative med, in other words providing

healthcare to people who ALSO see or have seen mainstream doctors, I

highly recommend becoming familiar with the concept known as A CONSULT.

 

Note I did not say Consultation, which has an unfortunate association

with the marketing strategy known as Free First Visit, and typically

consists of a ten minute sales pitch.

 

A CONSULT, or Specialty Consult, revolves around ackowledgement that a

patient already has a doctor who outranks you by virtue of either a.)

the gravity of their work, b.) the opinion of a Hospital and/or

Insurance companies, c.) the fact that their earnings vastly surpass

yours, or d.) the MERE FACT that the patient IS ALREADY IN THEIR CARE.

 

This should be basic standard of practice, ALONG with:

1.) Knowledge of quote-unquote Red Flags, which hinges on knowledge of

YOUR ability to meet MAINSTREAM standard-of-care (assessment through

treatment or discharge) for any condition that has potentially grave

consequences.

2.) Ability to TAKE a case and report All-and-Only the Essentials.

Most TCM training teaches extensive use of leading questions to match

people with patterns, rather than perceiving what IS, and evaluating

WHAT might be significant.

[ I personally learned to disregard bucketloads of information

through study of classical homeopathy; nowadays I've drastically

simplified with the simple question / filter of Functional status, and

goal of facilitating the next transition ]

In fact, when reporting to anyone, the significant requirement is to

cover all the bases that they (the reader) need to see to know that

you know what's going on (i.e. put the status in the reader's terms

first, THEN state _ in OUR field we use such-and-such terms to

describe this situation, we note this-and-that uniquely interesting

aspect, and we proceed with such-and-such plan to acheive

some-or-other desirable goal _.

 

Seeing a patient as a Consult does not preclude the possibility that

your training, expertise, and provision of services and/or product

might be Exactly the most appropriate / best thing for the patient.

It DOES properly put the doctor(s) still in control on notice and

advisement, and can be done in a way to encourage cooperation and

mutual respect.

 

The WAY to do this is to contact the (primary) doctor and state that

you have been contacted by one of their patients who is seeking a

second opinion, and they have signed an authorization to release

records, so you are interested in COORDINATING care to avoid problems

or any misunderstanding. Say (and believe) that you're NOT trying to

steal their patient ( ! ), and if you arrive at any recomendations you

intend to advise them (the primary doc) FIRST. If you haven't yet

seen the patient, you might nicely ASK for a written note giving a

referal for an Acupuncture Specialty Consult and Report, along with a

brief summary of history and status.

 

The objection to going about things in this manner is largely due to:

1.) Improper belief that you Should and Will treat the patient (even

BEFORE you have seen them ( ! )

2.) The patient's desire to keep their foray into alternative

healthcare a secret from mainstream doctors and insurance.

3.) Fear that review of the case records is going to immediately

clarify that you're out of your league.

4.) Fear that the doctor is going to scare the patient away from you.

 

IF you and the patient both arrive at a plan for treatment, and the

primary approves, then you become a TREATING doctor. If the primary

does not approve, then you must choose which relationship to continue

to respect the greatest. In ANY eventuality, being a responsible

practitioner mandates that you identify your own position and role

within the overall scheme of things, and act accordingly.

 

joe reid (copyright 05-29-08 not for reprint without author's express

permission)

www.jreidomd.blogspot.com

[Guest guest]

Hi Joe, I am sure many people have curiosity about the following point. Could

you elaborate, because I 'm having difficulty understanding your idea:

 

You wrote:

---

2.) Ability to TAKE a case and report All-and-Only the Essentials.

Most TCM training teaches extensive use of leading questions to match

people with patterns, rather than perceiving what IS, and evaluating

WHAT might be significant.

---

 

 

Thanks,

Hugo

 

 

 

________

Sent from Mail.

A Smarter Email http://uk.docs./nowyoucan.html

 

 

[Guest guest]

CONSULT ( Part 2 )

This is a follow-up to my last post, a brief article suggesting

Licensed Acupuncture / TCM practitioners adopt _Consult_ as a

preferred way to see any new patient who ALSO sees or has been to

mainstream doctors. It should be the standard for integrative care.

In general terms, integration of cultures or systems is a more

challenging task than choosing to remain in isolation, yet that choice

is often not really ours to make.

 

Case-Taking, and what constitutes ALL-and-Only Essentials most

obviously differs according to type of practitioner, type of patient,

and who will read any reporting of the case. When dealing with a

person already bearing a _western_ diagnosis (or history of), and who

IS or WILL likely return to care of modern _western_ doctors, crucial

elements (Essentials) of that diagnosis should be addressed / reported

IN THEIR TERMS. That starts with having _some_ familiarity with the

parameters of that diagnosis. If they come in with a _hypertension_

label, they should get a cuff on their arm within the first few

minutes and that stat included prominently in your report.

 

Restricting your questioning, analysis and potential intervention to

Only what YOU determine to be Essential is very much a product of your

knowledge, experience, and suitability to the case. It is not

uncommon for practitioners to have their own _hit list_ of items that

they want to proselytize about, including diet, habits, and suspected

exposures that are _bad_. Consequently, their Tx plans and reports

tend to be full of very irrelevant information.

 

Additionally compounding this problem is overuse of Leading Questions.

Asking a series of questions that increasingly point in your mind to

a pattern that you have learned / been taught, for the purpose of

confirming and validating that notion, increases the likelyhood that

those questions are _leading_. Unless you are VERY careful to ask only

in the most open-ended way, it is very easy to spoil the quality of

info elicited by _feeding_ ideas to the patient (or yourself). This

is the quickest route to superfluous, non-essential, or just plain

wrong data. And yet, due to pattern memorization (the way TCM is

taught), avoiding leading questions becomes an advanced skill that

must be deliberately cultivated.

 

Specific _direct_ questions are most appropriate when phrased in your

mind to yourself as you consider already elicited info and compare it

to established algorithms. Also, for triaging suspected _red flags_,

there are appropriate direct inquiry clustered questions, for example

_HA? - stiff neck? - nausea?

 

The most important information is sometimes (or often) not the first

or main _quote-unquote problem_ spoken of or stated on a form.

Criticism of a _physical therapy_ type approach often stems from the

cliche of _Back pain? - Ok, well let's get to work on that right away

and we'll get you fixed up!_

 

Observing classical homeopathic interview was where I first learned to

appreciate the value of not playing to the patient / client's

expectations. Eizayaga frequently opened with _Why are you here?_,

and would follow with little other than occasionally repeating _What

else?_, sometimes for extended periods, until the client, through

forced internal searching in the presence of compassionate

non-judgmental acceptance, finally let their social facade go and

revealed an innermost side of their self.

 

Many of us are familiar with the profound quality of _breakthrough_

healing that stems from making a _deep connection_, regardless of what

technique we happen to be using at the time. It is in those moments

we realize that what is truly significant may have little to do with

somatized aches and pains, which are perhaps only a socially

acceptable manifestation of more central issues. Professional

practice of homeopathy involves a great deal more than allowing /

coaxing the _real_ person to show, yet that is the hallmark of the

best practitioners.

 

In a similar vein, I have come to view Functional Ability, ( that is

the degree to which a person can do whatever it is that they want /

need / strive to do ), as a far more significant indicator of

well-being than any label they come in with, whether Bio-medical, TCM

or other. This then, is the _filter_ I use to determine what is

Essential to the case. Maybe they do have qi4xu1, xue4yu1,

pi2yun4shi1re4, or feng1tong4, etc, or several overlapping. If you

manage to successfully pick the predominant pattern, AND get full Tx

regimen compliance leading to resolution, it is my opinion that those

results will still frequently be nowhere near as good as if you can

find what really MATTERS to them. When you can do that, it is not

unprecedented to see Sx patterns spontaneously resolve.

People with the skill to consistently tap in to client's depths may

well bring about healing without any regard to patterns. I take TCM

patterns into account, and if I can _connect_, all the better, but I

settle for specifically targeting some aspect of Function that THEY

FEEL can stand improvement, and aim to facilitate THEIR OWN healing,

which is very different from me doing something to them.

 

Some of us aimed for the ideal of holistic healthcare ( remember that

phrase, anyone? ) with the notion that more perspectives would lead to

a more accurate overall understanding. Fexibility in shifting

viewpoint is a crucial element in bridging any type of cultural gap.

At the risk of dabbling and practicing a diluted form of whatever, the

plus for me has been adaptability. The downside of purists _learn one

thing and learn it well_ is potential for ignorance and inflexibility.

The ideals of holistic have for many alternative providers been

replaced by the slightly more practical concerns of integrated or

integrative healthcare. The REALITY of taking patients who have or

are seeing mainstream _western_ physicians is that WE have the greater

burden of responsibility. CONSULTS can be part of the solution.

 

joe reid (copyright 05-31-08 may not be sold, reprinted, modified or

distributed without author's express permission)

www.jreidomd.blogspot.com

***

 

Chinese Medicine , Hugo Ramiro

<subincor wrote:

>>>

Hi Joe, I am sure many people have curiosity about the following

point. Could you elaborate, because I 'm having difficulty

understanding your idea:

>>>

You wrote:

.... 2.) Ability to TAKE a case and report All-and-Only the Essentials.

Most TCM training teaches extensive use of leading questions to match

people with patterns, rather than perceiving what IS, and evaluating

WHAT might be significant.

>>>

Thanks, Hugo

<<<

[Guest guest]

Hi Joe. You wrote about consults etc and make some very important points which

I can agree with, working nearly full-time with MDs as I do. I feel a need to

take issue with the most offensive part of your post...please humour me...

which I have copied below:

 

You wrote:

---

Additionally compounding this problem is overuse of Leading Questions.

Asking a series of questions that increasingly point in your mind to

a pattern that you have learned / been taught, for the purpose of

confirming and validating that notion, increases the likelyhood that

those questions are _leading_. Unless you are VERY careful to ask only

in the most open-ended way, it is very easy to spoil the quality of

info elicited by _feeding_ ideas to the patient (or yourself). This

is the quickest route to superfluous, non-essential, or just plain

wrong data. And yet, due to pattern memorization (the way TCM is

taught), avoiding leading questions becomes an advanced skill that

must be deliberately cultivated.

---

 

Really the only point I wanted to make is that all questions are leading,

including " open-ended " ones. By definition a question defines the answer.

Open-ended questions, for example, can allow a patient or client to express

themselves with great latitude and great inaccuracy or vagueness. Furthermore,

given that western patients have been asking themselves a certain group of

questions (largely defined by conventional medicine no less), I don't find the

idea of leading them to new pastures unreasonable, that both I and they might

graze upon different grasses.

Of course, given your point regarding communication with MDs, I would agree that

it is necessary to ask a particular set of leading questions that will result in

a clinical picture appreciated and usable by certain MD groups, especially when

one is trying to develop a relationship with said MDs.

I have found, however, that once a relationship is established, the new pastures

remain useful.

One point that I myself find very important in your post is the idea regarding

our " hit lists " (which again, MDs also have). I can't speak for CM practitioners

but certainly many CAM practitioners have certain demons (like heavy metals)

which signs can be found most anywhere and most anytime. Again, there is a

problem with verification, or perhaps, as you put it, irrelevance. But

verification certainly. And if I am reading your implication correctly, our best

guess in a medical report to a doctor looks really bad on us. No tests, no

precedent, just an idea.

Anyway, I just wanted to complain about leading questions.

 

Hugo

 

 

 

________

Sent from Mail.

A Smarter Email http://uk.docs./nowyoucan.html

 

 

[Guest guest]

Hugo,

 

I'll see your comment and raise...

 

I agree with everything you said...however Joe may give the reader

the impression that leading questions are how MD's are trained, a

proper history should AVOID leading questions and keep questions as

open ended as possible. Now that being said I will concede that it

is often not done.

 

Wishing you wisdom,

Randy

 

>

> Really the only point I wanted to make is that all questions are

leading, including " open-ended " ones. By definition a question

defines the answer. Open-ended questions, for example, can allow a

patient or client to express themselves with great latitude and great

inaccuracy or vagueness. Furthermore, given that western patients

have been asking themselves a certain group of questions (largely

defined by conventional medicine no less), I don't find the idea of

leading them to new pastures unreasonable, that both I and they might

graze upon different grasses.

> Of course, given your point regarding communication with MDs, I

would agree that it is necessary to ask a particular set of leading

questions that will result in a clinical picture appreciated and

usable by certain MD groups, especially when one is trying to develop

a relationship with said MDs.

> I have found, however, that once a relationship is established, the

new pastures remain useful.

> One point that I myself find very important in your post is the

idea regarding our " hit lists " (which again, MDs also have). I can't

speak for CM practitioners but certainly many CAM practitioners have

certain demons (like heavy metals) which signs can be found most

anywhere and most anytime. Again, there is a problem with

verification, or perhaps, as you put it, irrelevance. But

verification certainly. And if I am reading your implication

correctly, our best guess in a medical report to a doctor looks

really bad on us. No tests, no precedent, just an idea.

> Anyway, I just wanted to complain about leading questions.

>

> Hugo

>

>

>

> ________

> Sent from Mail.

> A Smarter Email http://uk.docs./nowyoucan.html

>

>

[Guest guest]

Hey Randy and All,

What I wonder is how we can be sure that our questions are open-ended? I feel

it's a really difficult question that is inextricably intertwined with human

consciousness. If that is the case, then we need to change our language to

reflect that - i.e. avoid using the black and white definition of TCM = leading

questions (Joe wrote " ...due to pattern memorisation " ) and WM = non-leading

open-ended questions (or as Randy said " a proper history avoids leading

questions " ).

 

Maybe Joe was discussing a particular type of leading question, although I am

still struggling to understand what we're talking about. I am also struggling to

understand what Joe is talking about because I believe he addressing vital

issues in terms of creating professional connections to WM practitioners (as Joe

said, " IN THEIR TERMS " (his emphasis)). I just can't see through some of Joe's

language at this point.

 

Language is leading. Ideas are leading. Systems are leading. That's the whole

point of a system - to lead. Don't need to lead? Then ya don't need a system.

ALL SYSTEMS HAVE AGENDAS. A non-leading system is a non-functional system. A

system that leads without knowing how it leads is dangerous. A system that

leads, knowing how it leads, and being aware of its strengths and weaknesses

(its limits) is the ideal system.

Having said that, I have been present at many diagnoses carried out by MDs and

have witnessed how patients are lead into certain answers and prevented from

offering compounding, conflicting and complicating information.

This very notion of " ruling in or ruling out " - if only we were so simple,

consisting of switches that gave " on or off " responses! Fortunately we are not

that simple, and would rather show ourselves in the terms of spectrums and

trends. But when we rule in or out (and I also do that fairly regularly), we are

leading and defining something according to our system, our experience, and our

understanding, as Joe pointed out.

Again, the above notion works, to a degree - in acute care. Taken out of its

workable context it leads to the mismanagement of primary care that we see

rampant today.

 

So my questions to Joe and Randy are to please:

1. define what open-ended questions are

2. give real-world examples of open-ended systems

3. define what leading questions are

4. explicate how TCM engages in leading questions (to form patterns) whilst

western medicine does not (engage in leading questions to form fixed

disease-entity diagnosis)

 

1 & 3 are the most interesting to me.

 

Thanks,

Hugo

 

 

 

 

rparrny <rparrny

Chinese Medicine

Wednesday, 4 June, 2008 8:29:14 AM

Re: endocarditis etc See as CONSULT

 

 

Hugo,

 

I'll see your comment and raise...

 

I agree with everything you said...however Joe may give the reader

the impression that leading questions are how MD's are trained, a

proper history should AVOID leading questions and keep questions as

open ended as possible. Now that being said I will concede that it

is often not done.

 

Wishing you wisdom,

Randy

 

>

> Really the only point I wanted to make is that all questions are

leading, including " open-ended " ones. By definition a question

defines the answer. Open-ended questions, for example, can allow a

patient or client to express themselves with great latitude and great

inaccuracy or vagueness. Furthermore, given that western patients

have been asking themselves a certain group of questions (largely

defined by conventional medicine no less), I don't find the idea of

leading them to new pastures unreasonable, that both I and they might

graze upon different grasses.

> Of course, given your point regarding communication with MDs, I

would agree that it is necessary to ask a particular set of leading

questions that will result in a clinical picture appreciated and

usable by certain MD groups, especially when one is trying to develop

a relationship with said MDs.

> I have found, however, that once a relationship is established, the

new pastures remain useful.

> One point that I myself find very important in your post is the

idea regarding our " hit lists " (which again, MDs also have). I can't

speak for CM practitioners but certainly many CAM practitioners have

certain demons (like heavy metals) which signs can be found most

anywhere and most anytime. Again, there is a problem with

verification, or perhaps, as you put it, irrelevance. But

verification certainly. And if I am reading your implication

correctly, our best guess in a medical report to a doctor looks

really bad on us. No tests, no precedent, just an idea.

> Anyway, I just wanted to complain about leading questions.

>

> Hugo

>

>

>

> ____________ _________ _________ _________ _________ _________ _

> Sent from Mail.

> A Smarter Email http://uk.docs. / nowyoucan. html

>

>

[Guest guest]

Hi Hugo,

 

I got confused while reading your argument. I then realized that what

you are calling a system is what I would call an interview method.

However, what you present as a system does fit in part with the

conventional use of the term system. Anyway, it seems to me that we are

talking about physician centered vs. patient centered interviews.

Physician centered(directed) interviews tend to facilitate the doc's

goals vs. the open interview, which is patient centered and is intended

to elicit the patient's experience. When I was in a masters of medical

education program at USC, there was discussion about how open ended

patient centered interviews saved time in the clinic.

 

This Dr.-patient interaction is part of several systems. The

relationship between the two, the larger systems of the clinic, the

systems of reimbursement, and on and on...

 

From Wiki:

System (from Latin systÄ " ma, in turn from Greek

σÏστημα systÄ " ma) is a set of interacting or

interdependent entities, real or abstract, forming an integrated whole.

The concept of an 'integrated whole' can also be stated in terms of a

system embodying a set of relationships which are differentiated from

relationships of the set to other elements, and from relationships

between an element of the set and elements not a part of the relational

regime.

 

There are natural and man-made (designed) systems. Man-made systems

normally have a certain purpose, set of objectives. They are

“designed to work as a coherent entityâ€. Natural systems

may not have an apparent objective but they are sustainable, efficient

and resilient. There are many kinds of systems.

 

A system is a fundamental concept of systems theory, which views the

world as a complex system of interconnected parts. We determine a system

by choosing the relevant interactions we want to consider plus choosing

the system boundary †" †" or, equivalently, providing membership

criteria to determine which entities are part of the system, and which

entities are outside of the system and are therefore part of the

environment of the system. We then make simplified representations

(models) of the system in order to understand it and to predict or

impact its future behavior.

 

Addenda: I am referring to professional practitioners of AOM as

physicians and doctors here because I believe that they perform that

role in society. I also believe that the reason we are not all operating

with a doctoral title in terms of both the legal and degree

designations, is an economic and political form of closure and turf

protection.

 

 

Warmly,

 

Will

 

 

William R. Morris, DAOM, MSEd, LAc

http://theccrt.com/

http://www.aoma.edu/

http://www.pulsediagnosis.com/

 

When individuals come together with a shared intention, in a conducive

environment, something mysterious can come into being, with capacities

and intelligences that far transcend those of the individuals involved.

 

Chinese Medicine , Hugo Ramiro

<subincor wrote:

>

> Hey Randy and All,

> What I wonder is how we can be sure that our questions are

open-ended? I feel it's a really difficult question that is inextricably

intertwined with human consciousness. If that is the case, then we need

to change our language to reflect that - i.e. avoid using the black and

white definition of TCM = leading questions (Joe wrote " ...due to

pattern memorisation " ) and WM = non-leading open-ended questions (or as

Randy said " a proper history avoids leading questions " ).

>

> Maybe Joe was discussing a particular type of leading question,

although I am still struggling to understand what we're talking about. I

am also struggling to understand what Joe is talking about because I

believe he addressing vital issues in terms of creating professional

connections to WM practitioners (as Joe said, " IN THEIR TERMS " (his

emphasis)). I just can't see through some of Joe's language at this

point.

>

> Language is leading. Ideas are leading. Systems are leading. That's

the whole point of a system - to lead. Don't need to lead? Then ya

don't need a system. ALL SYSTEMS HAVE AGENDAS. A non-leading system is a

non-functional system. A system that leads without knowing how it leads

is dangerous. A system that leads, knowing how it leads, and being aware

of its strengths and weaknesses (its limits) is the ideal system.

> Having said that, I have been present at many diagnoses carried out

by MDs and have witnessed how patients are lead into certain answers and

prevented from offering compounding, conflicting and complicating

information.

> This very notion of " ruling in or ruling out " - if only we were so

simple, consisting of switches that gave " on or off " responses!

Fortunately we are not that simple, and would rather show ourselves in

the terms of spectrums and trends. But when we rule in or out (and I

also do that fairly regularly), we are leading and defining something

according to our system, our experience, and our understanding, as Joe

pointed out.

> Again, the above notion works, to a degree - in acute care. Taken out

of its workable context it leads to the mismanagement of primary care

that we see rampant today.

>

> So my questions to Joe and Randy are to please:

> 1. define what open-ended questions are

> 2. give real-world examples of open-ended systems

> 3. define what leading questions are

> 4. explicate how TCM engages in leading questions (to form patterns)

whilst western medicine does not (engage in leading questions to form

fixed disease-entity diagnosis)

>

> 1 & 3 are the most interesting to me.

>

> Thanks,

> Hugo

>

>

>

>

> rparrny <rparrny

> Chinese Medicine

> Wednesday, 4 June, 2008 8:29:14 AM

> Re: endocarditis etc See as CONSULT

>

>

> Hugo,

>

> I'll see your comment and raise...

>

> I agree with everything you said...however Joe may give the reader

> the impression that leading questions are how MD's are trained, a

> proper history should AVOID leading questions and keep questions as

> open ended as possible. Now that being said I will concede that it

> is often not done.

>

> Wishing you wisdom,

> Randy

>

> >

> > Really the only point I wanted to make is that all questions are

> leading, including " open-ended " ones. By definition a question

> defines the answer. Open-ended questions, for example, can allow a

> patient or client to express themselves with great latitude and great

> inaccuracy or vagueness. Furthermore, given that western patients

> have been asking themselves a certain group of questions (largely

> defined by conventional medicine no less), I don't find the idea of

> leading them to new pastures unreasonable, that both I and they might

> graze upon different grasses.

> > Of course, given your point regarding communication with MDs, I

> would agree that it is necessary to ask a particular set of leading

> questions that will result in a clinical picture appreciated and

> usable by certain MD groups, especially when one is trying to develop

> a relationship with said MDs.

> > I have found, however, that once a relationship is established, the

> new pastures remain useful.

> > One point that I myself find very important in your post is the

> idea regarding our " hit lists " (which again, MDs also have). I can't

> speak for CM practitioners but certainly many CAM practitioners have

> certain demons (like heavy metals) which signs can be found most

> anywhere and most anytime. Again, there is a problem with

> verification, or perhaps, as you put it, irrelevance. But

> verification certainly. And if I am reading your implication

> correctly, our best guess in a medical report to a doctor looks

> really bad on us. No tests, no precedent, just an idea.

> > Anyway, I just wanted to complain about leading questions.

> >

> > Hugo

> >

> >

> >

> > ____________ _________ _________ _________ _________ _________

_

> > Sent from Mail.

> > A Smarter Email http://uk.docs. / nowyoucan. html

> >

> >

[Guest guest]

Hugo,

 

I will give you the WM perspective and leave OM to Joe.

 

An open-ended question allows the respondent to reply in their own

words without guidance from the questioner. Ex: So tell me why

your here today vs. Are you here for your annual exam? You say you

have pain in your foot, can you describe it for me? vs. Does it hurt

when you walk?

As a student in the 80's back when AIDS was new for us, I remember a

history on an AIDS patient during my ER rotation. The main

complaint was diarrhea. Now I had just finished my medicine

rotation at a hospital with a high AIDS population and I had dealt

with a lot of AIDS diarrhea...I went through my battery of AIDS

diarrhea questions. All proud of myself, I present to the attending

who then walks into the room and asks the patient: " Any recent

travel? " " Oh yes, " she said, " I just got back from Mexico. " Back

then, I never even considered that an AIDS patient would consider

traveling, no less vacationing...and certainly not in Mexico. Well,

I learned my lesson that day. I think we all learn more from our

failures than from our successes.

Now on the flip side, there are patients that will go off on

tangents and tell you their life story if you let them. From a WM

perspective that is non-productive and you need to gently redirect

them back to why they are there to see you. Unfortunately, many WM

practioners start with directed questions in order to save time.

Considering some annual exams with certain health insurances are

reimbursed about $27.00 you can understand why some feel time is of

the essence.

Hope that answers things from a WM perspective

Wishing you wisdom,

Randy

 

> So my questions to Joe and Randy are to please:

> 1. define what open-ended questions are

> 2. give real-world examples of open-ended systems

> 3. define what leading questions are

> 4. explicate how TCM engages in leading questions (to form

patterns) whilst western medicine does not (engage in leading

questions to form fixed disease-entity diagnosis)

>

> 1 & 3 are the most interesting to me.

>

> Thanks,

> Hugo

>

>