measuring success/effectiveness of Chinese medicine treatments

June 10, 2009

I am at the starting stage of an investigation into systematic measurement of

success with any chinese medicine-based treatments.

Anyone interested in sharing what they use or systems they have seen to

accomplish this, specifically over a course of treatments?

I would be happy to share (summarized) what I find and I will appreciate

whatever any from our august group is willing to share. Explanations of HOW YOU

USE these tools will be additionally appreciated.

Mark Zaranski

student

June 10, 2009

For starters, you will have to have a very clear elaboration of what, precisely,

you mean by 'success'.

--- On Wed, 6/10/09, zedbowls <zaranski wrote:

zedbowls <zaranski

measuring success/effectiveness of Chinese medicine treatments

Chinese Medicine

Received: Wednesday, June 10, 2009, 5:51 PM

I am at the starting stage of an investigation into systematic measurement

of success with any chinese medicine-based treatments.

Anyone interested in sharing what they use or systems they have seen to

accomplish this, specifically over a course of treatments?

I would be happy to share (summarized) what I find and I will appreciate

whatever any from our august group is willing to share. Explanations of HOW YOU

USE these tools will be additionally appreciated.

Mark Zaranski

student

________________

Canada Toolbar: Search from anywhere on the web, and bookmark your

favourite sites. Download it now

http://ca.toolbar..

June 15, 2009

By not defining success, I left it an implicit question, expecting the answer

for the respondant would become clear thru their method of measurement.

So, Daniel, what precisely do you mean by success with your healing art and how

do you measure that?

I have heard a lecturer say " I treated him three times for the condition and had

complete success. " When questioned as to how he knew he had complete success

thru his chosen treatment strategy, he replied " I know it worked because the

patient never returned for more treatment. " Pretty clear what his definition

is.

Chinese Medicine , Daniel Schulman

<daniel.schulman wrote:

>

> For starters, you will have to have a very clear elaboration of what,

precisely, you mean by 'success'.

>

> --- On Wed, 6/10/09, zedbowls <zaranski wrote:

>

> zedbowls <zaranski

> measuring success/effectiveness of Chinese medicine

treatments

> Chinese Medicine

> Received: Wednesday, June 10, 2009, 5:51 PM

>

I am at the starting stage of an investigation into systematic

measurement of success with any chinese medicine-based treatments.

>

> Anyone interested in sharing what they use or systems they have seen to

accomplish this, specifically over a course of treatments?

>

> I would be happy to share (summarized) what I find and I will appreciate

whatever any from our august group is willing to share. Explanations of HOW YOU

USE these tools will be additionally appreciated.

>

> Mark Zaranski

>

> student

>

________________

> Canada Toolbar: Search from anywhere on the web, and bookmark your

favourite sites. Download it now

> http://ca.toolbar..

>

June 15, 2009

Zedbowls: So, Daniel, what precisely do you mean by success with your healing

art and how do you measure that?

Daniel: Well, for starters, anyone who says " I know it worked because the

patient never returned for more treatment. " is, to some degree delusional. I

mean, its a possibility for sure, but not the only possible reason the patient

'never returned' - a rational person with depth would be willing to entertain

and face into all the possible reasons the patient never returned.

This is really a huge topic and perhaps the single most important question for

every one of us in this profession to ask. But to be honest, trying to really

discuss it to any degree of depth usually on chatgroups seems to unleash a

cascade of vitriole - which, in itself, is interesting - don't you think? (I

mean, people usually only get mad if you have 'pushed a button')

Through - our diagnostic methods (pulse, tongue, asking,

palpating, etc etc) AND our entire body of conceptual frameworks - we have the

potential to open up just an incredible dialogue with each patient about their

symptoms, their lives, their histories, lifestyle, choices they are making, and

where they can go in the future.

So, just making a symptom go away over the very short-term would be the lowest

level of practice. And I don't mean to completely deny the value in that level

of practice. It most certainly has value and we all practice at that level with

many of our patients. But our medicine does have the potential for MUCH more.

An even lower level of practice would be to repeatedly make symptoms go away

for a repeatedly returning patient if there was no ongoing discussion of

habitual behaviours contributing to the condition. At some point in such a

scenario, its even possible to say the practitioner is no longer helping but

colluding.

To the degree one engages with the patient and uses their main complaint

(initial reason for coming for treatment) as leverage to go deeper and awaken

the patient to the full suite of signs and symptoms, their full set of

dysfunctionalities and their full set of choices moving forward - is the

framework against which a depth-dependant assessment of results and treatment

success would have to be erected. And the bottom of that barrel is so deep

indeed that it might, in fact, appear bottomless to most of us.

June 15, 2009

Interesting question. I have recently been doing presentations, in which I

report a 99% " improvement rate " . While this does not quantify how much

improvement, which is greatly variable from patient to patient, it does

absolutely mean that only 1 patient out of 100 has no improvement at all, within

the time frame they were comfortable with waiting for results. This could mean

that I could perhaps have a 100% improvement rate, if all of my patients kept

returning with adequate frequency and duration. I think this is noteworthy and

impressive!

What am I calling " improvement " ? Lessening of the symptoms of the chief

complaint, as reported to me by the patient.

Much to my surprise, my patients are by and large content to settle for

improvement, rather than being motivated to continue their care and follow my

recommendations towards possible eradication of their complaint. So rather than

use " cure " as my measurement for success, I use patient satisfaction for that

yardstick.

It might not be the same standard I would choose for myself as a measurement

(which would lean more toward " cure " ), but when I look for verification of my

success in that way, I am not in sync with my patients' goals. Besides, it is

much more gratifying when I measure success in the same way that they do.

Traditional Oriental Medicine

Happy Hours in the CALM Center

635 S. 10th St.

Cottonwood, AZ 86326

(928) 274-1373

--- On Sun, 6/14/09, zedbowls <zaranski wrote:

zedbowls <zaranski

Re: measuring success/effectiveness of Chinese medicine

treatments

Chinese Medicine

Sunday, June 14, 2009, 6:45 PM

By not defining success, I left it an implicit question, expecting the answer

for the respondant would become clear thru their method of measurement.

So, Daniel, what precisely do you mean by success with your healing art and how

do you measure that?

I have heard a lecturer say " I treated him three times for the condition and had

complete success. " When questioned as to how he knew he had complete success

thru his chosen treatment strategy, he replied " I know it worked because the

patient never returned for more treatment. " Pretty clear what his definition

is.

Chinese Medicine , Daniel Schulman

<daniel.schulman wrote:

>

> For starters, you will have to have a very clear elaboration of what,

precisely, you mean by 'success'.

>

> --- On Wed, 6/10/09, zedbowls <zaranski wrote:

>

> zedbowls <zaranski

> TCM - measuring success/effectiveness of Chinese medicine

treatments

> Chinese Medicine

> Received: Wednesday, June 10, 2009, 5:51 PM

>

> I am at the starting stage of an investigation into systematic

measurement of success with any chinese medicine-based treatments.

>

> Anyone interested in sharing what they use or systems they have seen to

accomplish this, specifically over a course of treatments?

>

> I would be happy to share (summarized) what I find and I will appreciate

whatever any from our august group is willing to share. Explanations of HOW YOU

USE these tools will be additionally appreciated.

>

> Mark Zaranski

>

> student

>

> ________________

> Canada Toolbar: Search from anywhere on the web, and bookmark your

favourite sites. Download it now

> http://ca.toolbar..

>

June 16, 2009

AB:

this is an interesting point you raise on the definition of success:

patients' being different, even a lower level than the clinicians' own

view.

as i read your post i was reminded of a current patient i am tx for

hypertension. she has been drug free and managed with acu/herbs at a

maintenance frequency for sometime, and has told me on several occasions

that she is quite happy to stay on a maintenance plan and to be off the

drugs.

like you, as a clinician, i would like a clinical cure, which i consider to

be no herbs/acu/drugs needed to maintain nml blood pressure.

in pondering this disparity, maybe it would be beneficial to determine the

patients goals on the initial visit. i was not taught to do this in acu

college. (we went to the same school, were you?) i give them what i know

to be an accurate prognosis of their condition based on my knowledge of tcm

efficacy rates and my personal clinical experience. maybe if i asked what

their expectations of tx outcome was, i might be surprised to get a

different answer than what i can comfortably predict the clinical prognosis

to be.

are others routinely asking patients of their expectations of tx on the

first visit, or even later on into tx in chronic conditions?

kath

On Mon, Jun 15, 2009 at 1:44 PM, <wrote:

>

> What am I calling " improvement " ? Lessening of the symptoms of the chief

> complaint, as reported to me by the patient.

>

> Much to my surprise, my patients are by and large content to settle for

> improvement, rather than being motivated to continue their care and follow

> my recommendations towards possible eradication of their complaint. So

> rather than use " cure " as my measurement for success, I use patient

> satisfaction for that yardstick.

>

> It might not be the same standard I would choose for myself as a

> measurement (which would lean more toward " cure " ), but when I look for

> verification of my success in that way, I am not in sync with my patients'

> goals. Besides, it is much more gratifying when I measure success in the

> same way that they do.

>

> Traditional Oriental Medicine

> Happy Hours in the CALM Center

> 635 S. 10th St.

> Cottonwood, AZ 86326

> (928) 274-1373

>

> --- On Sun, 6/14/09, zedbowls <zaranski<zaranski%40verizon.net>>

> wrote:

>

> zedbowls <zaranski <zaranski%40verizon.net>>

> Re: measuring success/effectiveness of Chinese medicine

> treatments

> To:

Chinese Medicine <Chinese Medicine%40yaho\

ogroups.com>

> Sunday, June 14, 2009, 6:45 PM

>

> By not defining success, I left it an implicit question, expecting the

> answer for the respondant would become clear thru their method of

> measurement.

>

--

Kath Bartlett, LAc, MS, BA UCLA

Oriental Medicine

Experienced, Dedicated, Effective

Kath's Blog about , Healthy Living & Spirituality:

http://acukath.blogspot.com/

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Formulated by Kath Bartlett, Traditional Chinese Herbalist

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www.AcupunctureAsheville.com

June 16, 2009

Kath,

I believe the issue of patient's goals were covered in our clinical counseling

classes. I don't know whether other LAc's ask the patients about their goals,

but I always do. And their own goals always fall short of what I would wish for

their well-being. I would say the percentage of patients I've seen who embarked

on a more comprehensive approach to their health, is the opposite of those who

are pleased with mere " improvement " of their condition. Maybe 2 percent. This

is a source of sadness and frustration for me.

Andrea Beth

Traditional Oriental Medicine

Happy Hours in the CALM Center

635 S. 10th St.

Cottonwood, AZ 86326

(928) 274-1373

--- On Mon, 6/15/09, wrote:

Re: measuring success/effectiveness of Chinese medicine

treatments

Chinese Medicine

Monday, June 15, 2009, 7:33 PM