The Modern History of Chinese Medicine
By Robert L. Felt
Co-author Understanding Acupuncture
With the liberalizations and economic reforms of the 1980's pragmatism was codified in the Three Roads Policy where traditional medicine was again permitted in the private sector, in essential competition with biomedicine and the TCM sponsored by the State. Western medicine is now dominant in the People's Republic of China. Recent estimates put the number of health care workers trained in acupuncture at more than a 1,000,000. Although the number who currently practice acupuncture is unclear, we do know that most are trained in traditional medicine, zhong yi, typically herbal pharmaceutics and acupuncture. How many practice acupuncture or herbal medicine alone or in combination is unknown but more than 300,000 traditional doctors have graduated from China's twenty-four medical colleges, where they received five or six years of training in basic biomedical sciences, internal medicine, acupuncture and herbal medicine. More than 30,000 assistant traditional doctors have graduated from three-year programs that offer the same subjects in lesser detail. There are many Chinese biomedical physicians who have attended abbreviated acupuncture courses and more than 2,000 physicians have graduated from both a traditional and a Western medical program. By the early 1980's over 1,000,000 Barefoot Doctors had been trained in six month to two-year programs. Today, these famous worker-practitioners are paramedics who learn essential pharmacotherapy, Western medicine and acupuncture techniques in Western-style programs. An unknown number of people have begun private acupuncture practice since it was again permitted. The details of the training of these practitioners are unknown.
Traditional formulas are far more popular in China than acupuncture, which retains its traditional lesser prestige. In recent years, however, with the ascendancy of acupuncture in the West, an influx of foreign students (and their much needed and wanted foreign currencies) has created an awkward imbalance in some of China's leading institutions of traditional medical education. Departments of acupuncture, typically far smaller than internal medicine and herbal medicine departments, have grown relatively larger and richer from foreign training fees.
The number of practicing acupuncturists is probably lower than the training statistics suggest. Acupuncture services are part of China's socialized medical system but increasing numbers of patients now pay out-of-pocket as China's private sector grows. It thus is unclear what percentage of the population receives acupuncture treatment. However, it is clear that TCM has played a significant role in the resolution of China's critical post-war health care crisis, and that it has re-earned a place, not only in the scheme of China's health care economics, but in the hearts and minds of the Chinese people.
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