TCM Yesterday and Today: An Ongoing Battle

Of course Traditional Chinese Medicine (TCM) has been around for a very, very long time–about 3000 years, maybe longer, depending on source. But how about TCM’s history in Canada? What about it’s history and progress in British Columbia?

There are many changes in the works now for my profession with the government reworking our regulations and changing how we operate. We’re not yet sure how that will play out with how we will be able to practice and continue to offer our best skills and knowledge to our patients, but this is certainly not the first time we’ve been through some rough bits.

The Ask

But first, my husband often tells me I need to talk in a “inverted pyramid” way. I normally start with all the background and details and then do the ask, but instead it’s easier if I give the key elements first, along with the ask, and then give the background.

So…I’m asking you to write to your MLA and to proregadmin@gov.bc.ca.

The main issue that’s a bit urgent now is that the government has put out proposed changes to the regulations document that details what a TCM professional can call themselves (titles), definitions of our profession and modalities we use to treat, what treatments we’re allowed to do (scope of practice), and what health services only authorized healthcare professionals can do (restricted activities).

That proposed document is now “paused” because of feedback they’ve received, but they will be putting out a new revised document, and we need them to have the wording that optimizes your health access with us.

1. The initial proposed document removed all the Chinese wording that helps us and the public define what we do. Tui na is a style of massage that we are specifically trained to do, so calling it “manipulative therapy” doesn’t represent that. They’ve replaced “Qi gong” with “Chinese energy regulation therapy,” “tai chi” with “Chinese shadow boxing,” “moxibustion” or “jiu” with “thermal stimulation,” “cupping” or “ba guan” with “suctioning,” and have no mention of other TCM therapies like “gua sha” (scraping). We want that wording back in. It’s a culturally-based whole medical system. Words matter, and removing that confuses our professionals and the public.
2. The titles are no longer present in the proposed document. So, there is no description of what the differences are between a registered acupuncturist (R.Ac.), registered TCM herbalist (R.TCM.H.), registered TCM practitioner (R.TCM.P.), or Dr. of TCM (Dr.TCM). R.Ac.s are trained and regulated to do acupuncture, but not herbs. R.TCM.H. are trained to prescribe Chinese herbs, but not do acupuncture. R.TCM.P. and Dr.TCM can do both, with requirements for the other registrants to be under the guidance of or refer to a Dr.TCM under certain specific situations. The titles need to be in the document to ensure the public gets the care their practitioner is trained, regulated, and insured to offer.
3. The proposed document removed prescribing Chinese herbal formulas from our restricted activities, so it’s now unclear who can do that. That needs to be added back into our restricted activities.
4. We need the new updated document to include the health services that are part of a modern practice of TCM. For example, while not everyone is trained to do it, I did receive training to do point injection therapy (PIT). The physiotherapists received an updated version of their regulations at the same time as the TCM professionals, newly officially allowing them to administer oxygen, do airway suctioning, perform needling (that has NOT been in their scope of practice, though they’ve long been doing it), and more. The TCM regulatory college, CTCMA, submitted documents after detailed consultations to the Ministry of Health (MOH), asking for an update to our outdated regulations document in both 2015 and 2017, but the updates were delayed time and again. They stated they would require specific training, insurance, and requirements for anyone offering any of these restricted activities. We would like the requests for our scope of practice and restricted activities from almost a decade ago to be integrated into the new regulation document.

So, if you use TCM services or plan to in the future, please write your input to let them know these things are important to you. What goes into these official documents can change what we’re allowed and not allowed to do.

The Background

And now for the fun stuff. This is why I normally start with this. I like the backstories and the details. It’s probably a big part of why I love what I do. I want to know my patients’ stories behind their current health issues and their lives.

Did you know that I could have been arrested or at least charged had I been practicing TCM in BC well into the 1980s? Luckily, I went to TCM school from 1998-2001, and I got to take the first licensing exam for acupuncture and the title of Registered Acupuncturist in 2001. Ditto for the first licensing exam for TCM herbology in 2002 and Dr. TCM in 2005 (though had I started and completed my studies two–or maybe three–years earlier, I could have applied to be grandfathered into the title).

My profession is complex. It is the only regulated health profession in Canada that is based on a complete medical system that is able to stand on its own, unlike most non-conventional medical practices that are founded on Western practice principles. It is called Traditional Chinese Medicine, but the “tradition” part is not traditional to the West. And, just because it is a long-standing practice, doesn’t mean it is the same as it was hundreds or thousands of years ago. It has continued to evolve and modernize. It’s called “Chinese,” but other nearby countries also began their own adaptations of this medicine long ago, and some of those practices have been incorporated. Our terminology for diagnosis and treatment is unique as well with a mix of Chinese names and imperfect translations.

I found this amazing interview with Mary Watterson, our first regulatory college registrar, on CBC about the origins of regulating TCM in BC, called “Chain Across the Door.”

She speaks about how people were secretly practicing TCM in Canada, afraid to be arrested, and how she and others lobbied and pushed to get TCM legalized and regulated so they could help more people. Acupuncture became a regulated health profession in 1996, and TCM became a regulated health profession in 2000. British Columbia led the way, and now acupuncture is regulated in Alberta, Quebec, Ontario, and Newfoundland, while TCM herbology and the TCM practitioner title are also regulated in Ontario. Only BC has the Dr.TCM title.

While it was legal and newly regulated when I started practicing, I found out that I had to explain what I actually did to most people I met. And the looks and I responses I got were priceless: “So, you get paid to poke needles in people?”, “Is that legal?”, “Why not just take drugs?” But others were excited to try it. They felt they had tried everything else without improvement, so they said, “Sure, I’ll give it a go.”

Now most people I speak to are at least familiar with acupuncture and the name “TCM” or “Traditional Chinese Medicine.” Acupuncture is now covered under most extended health insurance plans, by ICBC, and by WorkSafe BC. And pretty much every other healthcare profession wants a piece of our therapies, including acupuncture (dry needling, IMS, Gunn), gua sha (Graston technique), and cupping (myofascial decompression).

Our journey has not been easy, and our fight for equal recognition is not over, but TCM in Canada has come a long way, thanks to the passionate hard workers who came before us today.

If you want to know more about how you can support TCM and our ability to use all our skills to treat you, let me know!