CAM research:
trends and challenges.

Acupuncture: Medicine of the Fourth Kind

by Alex Tatevian DA

Southern New England Health Care Review; 2000; Vol. 10, Issue 3.

Conventional medicine developed from three medical milestones:
1) Herbs, the administration of substances that developed into allopathic medicine,
2) the knife, which evolved into surgery, and
3) the word, which gave us psychiatry.

These are used alone and in combinations to provide the most effective medical treatment. They mix, compete, interact, and invade each other's domain. For example, traditionally allopathic coronary disease now utilizes surgical applications, and H-2 Blockers and antibiotics deprive surgeons from gastrectomys.

Acupuncture does not fit into any of these three categories. Even herbology makes more sense than acupuncture for the western scientific mind. Medical professionals have to overcome intellectual and professional barriers to accept acupuncture as medicine of the fourth kind and not just as another supplementary technique.


There are basically three models of integration: multidisciplinary, interdisciplinary, and transdisciplinary.

Multidisciplinary describes the relationship between conventional and unconventional practitioners and their patients. There is no formal communication between practitioners to coordinate care. Patients are shy to tell their physicians that they go to an acupuncturist, and apologize to their acupuncturists that they see chiropractors, and so on. The patient takes the initiative and control, yet his approach to medical treatment is often trial and error.

The interdisciplinary approach to integrative medicine has become the recent trend in Rhode Island. More and more physicians feel secure to refer their patients to a licensed acupuncturist, a last resort when allopathic medicine has exhausted its options. Physicians have had little confidence in the efficacy of acupuncture, and when a positive outcome is achieved, continue the referral practice. There is no exchange of medical records, no follow up notes, and most importantly, no coordination of care.

The transdisciplinary approach is what I see as the ideal model of healthcare integration for acupuncture when it has evolved into a new entity. The best features of a trandisciplinary model are synchronized, coordinated, and optimazed care for the patient. The implementation of different therapies must be synchronized into a logical combination to effect the best possible medical outcome. To avoid poor and excessive treatment regimes, there must be coherent protocols. It is not an easy model to achieve, and we are a good distance away from actualizing it.

European Acupuncture

Traditionally associated with China, Japan, and Korea, acupuncture is incorporated into medical practice in Europe. Acupuncture was introduced in Europe by European physicians who brought it from Far Eastern colonies. That mode of introduction made it credible. The first known European acupuncture publication was dated 1671 and was published in Holland. Modern medicine as we know it today did not exist yet, and there were 300 years of parallel development, interaction, and scientific scrutiny.

There are similarities and differences in the contexts of European and Chinese acupuncture. The similarity is that there is close communication and contribution between acupuncturists practicing in Europe and China. European professional's practice based on the principles of Traditional Chinese Medicine. Chinese practitioners promptly accommodate and incorporate new European techniques such as electropuncture and concepts like auriculopuncture.

The difference is that European acupuncture coexists with highly advanced, state-of-the-art modern medicine, and Chinese acupuncture does not. Acupuncture in China quite often aims to replace conventional medicine to fill the gaps and deficits in healthcare.

The Next Step

Overloaded with sophisticated hardware, the medical field is starving without new fundamental ideas. The overwhelming advance of medical technology made possible practical realization of theoretical concepts developed by the previous generations of physicians and scientists. The medical field turned into a trillion-dollar industry and reached the point of saturation. Breathtaking achievements of modern medicine do not impress the public any more. Medicine has spent the last 100 years making people healthcare dependant.

Now we are trying to reverse that. Holistic medicine and prevention became the most recent medical paradigm and political statement. But so far it has not changed the philosophy of medical intervention. It may degrade into another round of making generally healthy people health care dependant with "all natural" supplements, life-style drugs and pointless acupuncture treatments.

Reliable statistical analyses are few as acupuncture in America is still too young. The marriage of classical acupuncture with modern technology opens new horizons for study. The problem with double blind studies can be resolved by replacing a traditional acupuncture needle with an infrared low energy laser. Modern scientific investigation of acupuncture points and meridians proved their actual existence, and has produced perhaps the only new fundamental concept formulated in the biomedical field in the last 60 years. If further research supports the idea of acupuncture channels as a new integrative system, it will be as major as the discovery of the nervous system.

Alex Tatevian DA
Southern New England Health Care Review; 2000; Vol. 10, Issue 3.