Similarities and differences between physician and non-physician acupuncturists in using diagnostic methods - an explorative study

Purpose: Acupuncture is one of the complementary medicine therapies with the greatest demand in Switzerland and many other countries in the West and in Asia. Over the past decades, the pool of scientific literature in acupuncture has markedly increased. The diagnostic methods upon which acupuncture treatment is based, have only been addressed sporadically in scientific journals. The goal of this study is to assess the use of different diagnostic methods in the acupuncture practices and to investigate similarities and differences in using these diagnostic methods between physician and non-physician acupuncturists. Methods: 44 physician acupuncturists with certificates of competence in acupuncture – traditional chinese medicine (TCM) from ASA (Assoziation Schweizer Ärztegesellschaften für Akupunktur und Chinesische Medizin: the Association of Swiss Medical Societies for Acupuncture and Chinese Medicine) and 33 non-physician acupuncturists listed in the EMR (Erfahrungsmedizinisches Register: a national register, which assigns a quality label for CAM therapists in complementary and alternative medicine) in the cantons Basel-Stadt and Basel-Land were asked to fill out a questionnaire on diagnostic methods. The responder rate was 46.8% (69.7% non-physician acupuncturists and 29, 5% physician acupuncturists). Results: The results show that both physician and non-physician acupuncturists take patients’ medical history (94%), use pulse diagnosis (89%), tongue diagnosis (83%) and palpation of body and ear acupuncture points (81%) as diagnostic methods to guide their acupuncture treatments. Between the two groups, there were significant differences in the diagnostic tools being used. Physician acupuncturists do examine their patients significantly more often with western medical methods (p<.05) than this is the case for nonphysician acupuncturists. Non-physician acupuncturists use pulse diagnosis more often than physicians (p<.05). A highly significant difference was observed in the length of time spent with collecting patients’ medical history, where nonphysician acupuncturists clearly spent more time (p<.001). Conclusion: Depending on the educational background of the acupuncturist, different diagnostic methods are used for making the diagnosis. Especially the more time consuming methods like a comprehensive anamnesis and pulse diagnosis are more frequently employed by non-physician practitioners. Further studies will clarify if these results are valid for Switzerland in general, and to what extent the differing use of diagnostic methods has an impact on the diagnosis itself and on the resulting treatment methods, as well as on the treatment success and the patients’ satisfaction.

The Inverted Phantom Giant

In his famous children’s book, “Jim Button and Luke the Engine Driver”, Michael Ende describes a curious character: A phantom giant. Clothed in rags and with a long beard, the phantom giant appears enormous from far away, but shrinks to normal size as one gets closer. Most people avoid the poor creature, but the ones that dare approach it encounter a gentle, lonely being called Mr. Tur Tur. Chemical ecology is just the opposite of Mr. Tur Tur: A phantom dwarf. Or, in other words, an inverted phantom giant. From a distance, chemical ecology appears like a slightly odd, marginal section of biology and chemistry. But, as the interested scholar approaches, it starts growing and very quickly reaches gigantic dimensions, because all life is explained by chemistry, and all biological chemistry is guided by ecological principles. Herein lies the difficulty with chemical ecology: As it is not perceived well by biologists and chemists, few approach it to understand its significance, and the ones that do find themselves in front of a giant that defies their attempts to define and contain it. This is where the Journal of Chemical Ecology comes in: It invites us to take a closer look at an underestimated discipline and supports us to explore it and deal with its multidimensionality through the promotion of knowledge and methods. These services are unique and make the journal stand out of the crowd of scientific journals. Writing children’s books has become difficult in the era of information technology. And, so has the job of the Journal of Chemical Ecology. Young scientists gather information through accessible, dynamic websites and social platforms. They want articles that are available through a single mouse click, anywhere, anytime. They prefer advanced interactive hypertext protocols over clumsy pdf files. They care about transparency, non-profit and open access just as much as about traditional journal properties. In my view, reaching “the kids” is the major challenge of the Journal over the next years. Promoting an inverted phantom giant in the 21st century requires a combination of high-quality information and boosted visibility. In Michael Ende’s book, Jim and Luke follow exactly this strategy with Mr. Tur Tur: They become friends and offer him a job as a living lighthouse to protect their small island. They combine a quality relationship with high visibility, et voilà, the story ends well! I am looking forward to seeing if the Journal of Chemical Ecology will follow a similar path to reach the next generation of biologists and chemists. If yes, there is a good chance that in 40 years from now, somebody will write a laudation and refer to another famous book by Michael Ende: “The Neverending Story”.