The status of Traditional Chinese Medicine in Canada.
This article will demonstrate that Traditional Chinese Medicine (TCM) is well established within Canada. This is seen in the trends that include it and in its widespread institutionalization. Canadians are increasing their use of alternative medicine. Furthermore, TCM is an important form of treatment in various hospitals, is widely commercialized, is covered under many health insurance schemes, is regulated by four provinces and the federal government, has its own regulatory bodies and teaching institutions, and is taught in the public education system. Arguably, its presence will grow as this institutionalization continues to highlight TCM's fundamental values.
Cet article presente a quel point la Medecine traditionnelle chinoise (MTC) a bien sa place au Canada. On peut voir comment elle fait partie des tendances et a quel point elle est largement institutionalisee. Les Canadiens font de plus en plus appel a la medecine alternative. De plus, la MTC est une forme importante de traitement dans divers hopitaux, elle est considerablement commercialisee, elle est couverte par plusieurs plans d'assurance sante, elle est soumise aux regulations imposees par le gouvernement de quatre provinces et par le federal, elle a ses propres agences de reglementation et etablissements d'enseignement, et on en donne des cours dans le systeme public d'education. Sa presence va sans doute s'etendre du fait que cette institutionalisation continue de mettre l'accent sur les valeurs fondamentales de la MTC.
The value of Canada's policy of multiculturalism becomes apparent when one sees the practical benefits it leads to. When these benefits are integrated into everyday life, they provide even stronger justification for supporting the policy. A case in point is Traditional Chinese Medicine. TCM is being integrated into the Canadian mainstream, thereby creating a clear example of the benefits of multiculturalism.
Obviously, multiculturalism is a complex concept and occurrence. Part of this complexity is the encouragement of cultures different from that of the mainstream to establish themselves in a Canadian setting. There are many reasons for this encouragement, one being the creation of familiar environments for entrants to Canada, which helps them to adapt and transition into greater involvement in Canada. Multiculturalism also provides direct benefits to the mainstream population, an example being that this encouragement leads to offering the mainstream alternative ways to meet daily needs. In short, there is a greater range of options available. There are, of course, further-reaching benefits derived from multiculturalism, such as the social harmony that is created when members of different cultures are able to practise them within the same physical environment. However, one of the strongest arguments in support of multiculturalism has to be its contribution to meeting the practical needs of those who provide most of the support for its implementation.
TCM is a specific example of an option created under the policy of multiculturalism that meets the needs of the whole population and, in doing so, offers evidence that the policy of multiculturalism is of benefit to the population as a whole. Under the auspices of this policy, government and business have been promoting the institutionalization of TCM. The result has been the development of an alternative medical system that offers services and treatments to the whole Canadian population.
The term "Traditional Chinese Medicine," while now applied clearly to a host of medical techniques that originated in China, was not used until the 1950s when the Chinese government decided to consolidate what was the diverse body of Chinese medicine in order to better harness its benefits. Part of this process was to create a system and coherent body of knowledge that could be integrated with the system of Western medicine that was being practised in China.
The government, in order to create a coherent body of knowledge on Chinese medicine, set up four academies to organize Chinese medical knowledge, to compile textbooks, and to train teachers. It subsequently published standardized textbooks of TCM, then set about to establish TCM as a valid medical system within the national health care system. This moulding of the diverse forms of medical knowledge then extant within China into a coherent body was also to contribute to its ultimate integration with Western medicine (Taylor 2005, 84, 87).
The construction of TCM by the government of China is relevant to its development in Canada because it is likely that the focused efforts of the government will produce a system that is attractive to Chinese and non-Chinese alike. One already finds the sophisticatedly prepared and packaged products of Chinese medicine producers on the shelves of TCM practitioners and health food stores across Canada. There will also be a tendency to integrate TCM and conventional Western medicine that accompanies the appeal of TCM.
Whatever the case, one already finds the term in widespread use across Canada. Regulatory organizations, such as the College of Traditional Chinese Medicine Practitioners & Acupuncturists of British Columbia, and teaching institutions, such as the Alberta College of Acupuncture & Traditional Chinese Medicine, use the term in official titles. The search engine Factiva locates 104 individual uses for the full term in the last year of Canadian news reports. There are a number of different techniques or practices in TCM. Diet, of course, is a major one; others include the use of herbs as prescriptions, acupuncture, massage, and qigong.
The benefits of TCM are seen in the health of typical TCM users and as Canadians turn more to alternative forms of medicine. Richmond residents, of whom 40 percent are ethnic Chinese, live an average of 83.4 years, longer than anywhere else in Canada (Armstrong 2005, A3). A study of Alberta's population, from 1995 to 2003, found that life expectancy at birth for ethnic Chinese residents was on average nearly six years longer than for non-Chinese (Quan et al. 2007, 500). A 2007 report showed that at least 50 percent of Canadian adults were using one or more natural medicines.
Moreover, the use of TCM is supported by a broad infrastructure and an intricate system of regulation and training. This infrastructure includes a number of hospitals and over a thousand private practitioners that offer TCM treatment. Large Canadian companies (e.g., Afexa Life Sciences) produce herbal medicines, and farmers produce millions of dollars worth of ingredients (e.g., Ontario, North American ginseng). Workers' compensation boards, some insurance companies, and even Veterans Affairs Canada have provided coverage for acupuncture. As for the system of regulation and training, the federal and four provincial governments regulate it, and the industry governs itself and provides a number of reputable academies devoted to training in TCM.
Adding to these trends are efforts by the government of the People's Republic of China. As early as the 1950s they began consolidating the fragmented research that was spread over the field of what was referred to as "Chinese medicine." They then methodically set about to promote, both domestically and internationally, what was a new science. The result was the formation within China of an institutionalized system of medicine that runs parallel with what is referred to as "Western medicine" and has spawned an important agricultural industry. Abroad, China has increased exports of TCM products and sought to establish global standards for the practice of TCM.
The contents of this article are based on literature searches. These included surveys of newspaper articles, news magazines, research publications, and websites, particularly those of teaching institutions and practitioners. The primary purpose in these searches was to document the presence of TCM in Canada. There is some risk that practitioners and private teaching institutions may have exaggerated the presence of TCM in Canada; therefore, an attempt was made to incorporate information from academic and government sources. While these latter may not be able to confirm claims about specific organizations, particularly private ones, they were able to support the general claims about the presence of TCM in Canada.
There are a number of studies that have shown the increasing use of alternative medical treatments among the Canadian population. For example, a 1997 poll showed that about 42 percent of Canadians were using some form of complementary health care, the most popular being chiropractics, herbal medicine, acupuncture, and homeopathy (Yip October 1999, 17). Furthermore, in 1999, the Canadian Health Food Association, a group representing herbal manufacturers and distributors, estimated that health supplements, including herbal derivatives, were a $2-billion industry in Canada, and growing (Yip October 1999, 17). A 2007 report confirmed this trend by finding that at least 50 percent of Canadian adults were using one or more natural medicines (MacLeod 2007, 14), such as American ginseng and Chinese wolfberry. These studies support claims that alternative medicines are becoming well established within present-day Canada. The claim for increased use is also supported by the gamut of treatments that are being tried, from externally administered (e.g., acupuncture, massage, and even meditation) to the internal consumption of more natural forms of medicines, such as unrefined herbs. This shows that Canadians are becoming broadly familiar with TCM.
An interesting case that brings to light the popularity of TCM is that of Cold-FX, a treatment for colds and their prevention, produced by Afexa Life Sciences. Cold-FX has been the top selling Canadian cold and flu remedy since 2004 ("Cold-fx" n.d.). Its main ingredient is North American ginseng, which is one of Ontario's highest revenue-earning agricultural crops.
TCM's integration into Canadian society is most clearly seen in the area of institutionalization. It is an important form of treatment in various hospitals, is widely commercialized, is covered under many health insurance schemes, is regulated by four provinces and the federal government, has its own regulatory bodies and teaching institutions, and is taught in the public education system.
There are a number of noteworthy organizations practising TCM within or in association with Canadian hospitals; for example, the Acupuncture Clinic at St. John's Rehabilitation Hospital in Toronto. Mount Sinai Hospital in Toronto provides acupuncture treatment in both its Rehab and Wellbeing Centre and the Wasser Pain Management Centre. Health Works, a rehabilitation clinic located in the Regina General Hospital, also provides acupuncture treatment. For nearly seven years, from 1996 to 2003, the Tzu Chi Institute for Complementary Medicine at Vancouver General Hospital provided integrative health care using new and innovative models (Mulkins et al. 2003).
One is also able to observe deep institutionalization in TCM's commercialization. A search of the Yellow Pages directories for Toronto, Vancouver, and Calgary respectively uncovered 559,262, and 157 practitioners of acupuncture. The total is 978 and this number does not include those practitioners who advertise solely through the Chinese language media. The same search for herbalists turns up 137, 56, and 22 in the respective cities for a total of 213. A 2005 report estimated that 650 stores in Canada featured traditional Chinese medicines (Healthy Choices 2005, 35). (1) The achievements of Afexa Life Sciences also convey the degree of TCM institutionalization in Canada. Afexa is a large scale TCM manufacturer headquartered in Calgary, Alberta. It is capitalized for about fifty million dollars and was recently acquired for $88 million by the Canadian pharmaceutical company Valeant.
Two other significant areas of commercialization of TCM are in Canadian agriculture and medical insurance coverage. Commercial agriculture ranges from the more exotic antler ranches, to the more common ginseng farms. Ginseng has been exported to China from Canada since 1721 (Dorff 2004, 297), and in 2005 crop production was worth $70 million, a huge increase from 1980 when it was only worth $2.8 million (Statistics Canada n.d.). From 1994 to 2003, North American ginseng was Ontario's fifth largest cash crop (Asia Pacific Foundation 2003, 6).
As for insurance coverage, taking the United States as a reference, in 2004,47 percent of Americans enrolled in employer health insurance plans were covered for acupuncture treatments (Claxon et al. 2004, 106-07). In Canada, workers' compensation boards in B.C., Alberta, Manitoba, Yukon, and Ontario, and some insurance companies, such as Pacific Blue Cross and Maritime Life, and even Veterans Affairs Canada have provided coverage for acupuncture (Asia Pacific Foundation 2003, 4). The Insurance Corporation of British Columbia also covers the costs of acupuncture (International College of Traditional Chinese Medicine of Vancouver), as does the Worker Safety and Insurance Board in Ontario (McMaster University Health Sciences, Medical Acupuncture Program).
In Canada, where health policy is the mandate of provincial governments, they have shouldered most of the responsibility for regulating TCM. This has created variations across the country where presently only four provinces formally regulate it. Nevertheless, a trend of following the lead of British Columbia seems to be developing, particularly in regulating the practice of herbal medicine and establishing industry self-regulation in the form of colleges. The federal government has also been involved, mainly in attempting to regulate standards for the ingredients of herbal medicine. As regulation increases and federal legislation impacts the industry, there have been efforts to harmonize regulation across the nation.
In 1996 the B.C. Ministry of Health established the self-regulating College of Acupuncturists. The college awarded licenses to practise acupuncture for the first time in 1999 (Canadian Press NewsWire 1999). Its responsibilities were transferred to the newly formed College of Traditional Chinese Medicine Practitioners & Acupuncturists of British Columbia in 2000 when the regulations surrounding TCM were broadened to cover the prescribing of Chinese herbal medicines. British Columbia was the first jurisdiction to bestow professional titles on those who practise TCM. Also, in 2003, British Columbia became the first jurisdiction in North America to officially license the practice of herbal medicine (Chiu 2006, 99).
The Transitional Council of the College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario was established in 2008. The council was charged with establishing the College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario and with developing the regulations and standards of practice in order to provide quality TCM to the Ontario public.
The need to regulate acupuncture was recognized early in Quebec where in 1973 it was officially placed under the control of the Corporation professionnelle des medecins du Quebec (Professional corporation of physicians of Quebec) (later to become College des medecins du Quebec [Quebec College of Physicians]). The first accreditation exam for acupuncturists took place in 1986. In 1995 the Ordre des acupuncteurs du Quebec (Quebec order of acupuncturists) was formed and charged with regulating the profession including awarding titles, creating exams, and discipline.
Acupuncture has been regulated in Alberta since 1988 under Alberta's Health Disciplines Act--Acupuncture Regulation. One must meet conditions set by the Acupuncture Committee established under the Health Disciplines Act in order to practise. These conditions include required training and educational standards.
Government of Canada
At the national level, one of the earliest moves to regulate TCM was the creation of the Office of Natural Health Products (later renamed Natural Health Products Directorate) by Health Canada in 1999 (Gnirss 1999, 33). Its mandate is to oversee all aspects of natural health products, including safety, accuracy of health claims, standards, licensing, enforcement of standards, and research. The Natural Health Product Regulations came into effect in 2004 with a six-year transitional period for implementation. Under these regulations all manufacturers were required to have site licenses and employ Good Manufacturing Practices by the end of 2005. By the end of 2007, manufacturers were required to provide evidence of their products' safety and effectiveness and to obtain a license and natural product number. Natural health products are allowed to use "traditional references in which folkloric use of a product is well documented" as evidence of safety and effectiveness (Hutty 2004, CE1-4).
Also taking place on a national level are efforts to standardize acceptable qualifications for TCM practitioners. There are factors driving these efforts. The main one is the 1994 Agreement on Internal Trade signed by the Canadian federal, provincial, and territorial governments allowing for the movement of qualified workers across provincial and territorial boundaries. This has increased the likelihood that TCM practitioners recognized in one jurisdiction could practise in another, thus creating the need for common standards across jurisdictions. In response, the Canadian Alliance of Regulatory Bodies for Traditional Chinese Medicine Practitioners and Acupuncturists (CARB) has been established.
CARB is composed of the College of Traditional Chinese Medicine Practitioners and Acupuncturists of British-Columbia; the Transitional Council of the College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario; the Chinese Medicine &c. Acupuncture Association of Newfoundland & Labrador; the Acupuncture Committee, Health and Wellness of Alberta; and the Ordre des acupuncteurs du Quebec. In 2009 CARB issued a list entitled "Entry-Level Occupational Competencies for the Practice of Traditional Chinese Medicine in Canada" that was recommended to provincial authorities for their adoption.
Self-Governing and Teaching Institutions
There are other types of organizations involved in the promotion of TCM in Canada besides those that have an official role in regulating it. Two important ones are operated solely by practitioners and have the roles of self-governance and teaching.
There are two national associations--the Chinese Medicine and Acupuncture Association of Canada (CMAAC) and the Canadian Society of Chinese Medicine & Acupuncture (CSCMA)--and several provincial associations that promote TCM within Canada. All of them are operated by members of the TCM industry. The CMAAC began in 1983 with a mandate to lobby for regulation of TCM. There are eight chapter offices across Canada. It lists among its objectives the establishment of high standards of education and training for TCM practitioners and it has been active in obtaining professional liability insurance for its members. The CSCMA was established in 1994. It too has a mandate to promote TCM regulation in Canada and claims to have had 2300 members as of 2010.
One of the more active provincial organizations is the Traditional Chinese Medicine Association of British Columbia (TCMABC), which was founded in 1992 with a mandate to serve TCM practitioners. In 2010 it joined with the British Columbia Qualified Acupuncturists and Traditional Chinese Medicine Practitioners Association in efforts to unify the profession and create a stronger voice.
The number and sophistication of institutions that teach the practice of TCM is high and they are found all over Canada. Generally, there are two types of teaching institutions: private schools, which have developed quickly, and public institutions that have recognized the need for critical research of medical techniques that offer much promise while receiving popular support.
A 2010 survey of telephone directories for Toronto, Vancouver, and Calgary respectively found fourteen, four, and four TCM schools in each of these cities. An internet search uncovered a total of twenty-three schools in the three provinces of British Columbia, with eleven schools, Ontario, with eight, and Alberta, with three. (2) There are examples of remarkable educational development among these schools. The International College of Traditional Chinese Medicine of Vancouver claims to have 120 students, fifteen faculty members, and occupies 650 square meters of space. The school offers the four diploma programs--a five-year program for Doctor of Traditional Chinese Medicine, a four-year program for Traditional Chinese Medicine Practitioner, a three-year program for Acupuncturist, and a three-year program for TCM Herbalist--permitted under provincial regulations. As well, it provides one-year programs in tuina massage and reflexology and opportunities to intern abroad.
The Alberta College of Acupuncture & Traditional Chinese Medicine in Calgary was founded in 1997 and was the first TCM institution in Alberta. It offers a three-year acupuncture program, a four-year TCM program, a graduate program, and courses in auricular medicine (ear acupuncture). It is also the Canadian Education Centre for Beijing University of Chinese Medicine. (3) The Alberta College of Acupuncture & Traditional Chinese Medicine is also one of two Canadian schools--the other being Toronto School of Traditional Chinese Medicine--accredited by the National Certification Commission for Acupuncture and Oriental Medicine in the United States. It is also noteworthy that alumni of the college identify themselves as such and the college's website includes a page devoted to them with job postings and announcements of social events.
The Toronto School of Traditional Chinese Medicine was founded in 1995. It offers diploma programs in Traditional Chinese Medicine, acupuncture, Chinese herbal medicine, and tuina massage.
The Canadian Institute of Traditional Chinese Medicine in Calgary was established in 2004. Sixteen instructors teach a variety of programs including a four-year acupuncture diploma program, a four-year doctor of TCM program, and a five-year bachelor degree in TCM including a one-year internship in a Chinese teaching hospital, as well as specialized programs in auricular medicine.
The presence of instruction on TCM in the public education system shows further progress in the acceptance of TCM. While private TCM schools may be more motivated by the profit accruing from tuition fees, public education often has to justify the use of public funds to conduct the research and offer the instruction that supports its curriculum. This justification requires critical examination; thus, any ensuing approval is greater evidence of the acceptance of TCM.
As in the private sector, there is a surprisingly large number of initiatives to promote TCM within public education. In British Columbia, Thompson River University (Kamloops) recognizes the academic credits earned at Canadian College of Acupuncture and Oriental Medicine (Victoria) toward their Bachelor of Health Science degree. Students can transfer as much as 75 percent of their credits from the college.
The University of Alberta has offered the Certificate Program in Medical Acupuncture since 1991. The program entails two hundred hours of instruction over an eight-month period. It is estimated this course has contributed to about 15 percent of Alberta's dental students becoming proficient in acupuncture (Kent 2000, 484). Furthermore, the Complementary and Alternative Research and Education Program in the Department of Pediatrics at the University of Alberta is conducting a number of research projects on TCM, such as the use of TCM to treat fatigue. Grant MacEwan University (Edmonton) offers the three-year Acupuncture Program that prepares one to become a registered acupuncturist in Alberta.
In Ontario, McMaster University offers the Contemporary Medical Acupuncture Program, which began in 1998 after acupuncture was introduced to the university in 1984 as part of its Acupuncture/Pain Clinic. The program includes 126 hours of class instruction spread over five weekends, which are spread over four months, and 174 hours of assignments (Taggart 2002, n.p.). The program is particularly suited to those who are already medical professionals. Ryerson University's G. Raymond Chang School of Continuing Education offers nine courses on TCM ranging from "Foundations of Chinese Medicine" to "Risk Management in Traditional Chinese Medicine."
In Quebec, the College de Rosemont (Montreal) offers a three-year program in acupuncture. Graduation from the program entitles students to write the examination of l'Ordre des acupuncteurs du Quebec. Those who successfully complete this examination become registered acupuncturists and are granted a work permit in Quebec.
The variety of TCM offerings within public education is also notable. There are major multi-year programs, initiation courses, and those targeting specific groups, such as McMaster's, which attracts many international students.
FUTURE TREND: CONTINUED INTEGRATION
If the degree of integration of TCM into Canadian society is surprising, then it will be further informative to know that this trend will probably intensify. There are reasons for thinking that this will be the case. TCM has fundamental value that will continue to attract a greater number of users. It already has established a strong base in Canada from which to develop further and it has momentum from the gains that it is making. Furthermore, one is beginning to see significant examples of its integration into the mainstream medical system.
Reasons for Continued Integration
TCM has strong appeal to a Canadian public that is already accustomed to the array of choice that multiculturalism offers and at the same time, unlike any other Western countries, perceives large-scale immigration as a public good (Simpson 2011, F.9). Nonetheless, this appeal also derives from the fundamental values that TCM offers. Three of these values are apparent at first glance: TCM is economical, encourages involvement in one's own health care, and has an established record in providing pain relief.
For TCM, the cost of researching health supports and cures for illnesses has been borne over the thousands of years of its history. Its ingredients, instruments, and methods are mostly simple and therefore less expensive. The result is that, compared to Western medicine, it is much less expensive to treat patients using TCM.
TCM has been practised in China from as early as 1500 BCE (Reid 1987, 19) and there were hundreds of herbal prescriptions in existence by the sixteenth century. One example was the use of marine algae (kelp) to prevent and treat goiter that was described in Ge Hong's (283-343) Handbook of Prescriptions for Emergencies (Weng and Chen 1996, S11). The practice of TCM was also very fragmented, with knowledge and skills retained within family businesses. However, since the Chinese Communist Party assumed control of China in 1949, they have consolidated and strongly promoted TCM. They gathered the knowledge, disseminated it, created training institutions, and made the practice of TCM an important part of the Chinese medical system. Furthermore, they expanded TCM abroad by exporting the skills, tools, and ingredients and attempting to establish common standards for its practice.
The ingredients and tools, also derived from early investigations, reflect their origin in periods of simpler, thus less expensive, technology. Herbs are grown and harvested, sometimes in the wild, putting their price often at the level of foodstuffs. In comparison, Western medicines are most often complex pharmaceuticals whose creation and testing run into millions of dollars. Likewise, Western medical equipment is not only expensive but continually evolving, making the provision of the latest techniques for diagnosing and treatment very costly. Like its medicinal ingredients, TCM's tools are simple. They include needles for acupuncture and charts for its meridians. The needles have been modified to carry an electric current and to be disposed after use, but these are not major expenses.
The result of this history, the simplicity of ingredients, tools, and techniques, and the Chinese government's recent efforts, has been that TCM treatment is readily and inexpensively available. Thus, some insurance companies are willing to compensate their policy holders for multiple acupuncture treatments in a year. Private practitioners operate in competition with the free-of-charge, public health system. At least part of their appeal and thus ability to continue in business is their low cost, a fact that has not escaped administrators in the mainstream medical system. Randy Wong, a former hospital head, as registrar of the College of Traditional Chinese Medicine Practitioners and Acupuncturists of British Columbia, points out that it is more cost-effective to treat some ailments and chronic conditions with visits to a herbalist or acupuncturist that cost $50 or $ 100 than with $500 to $ 1,500-a-day hospital admissions (MacQueen 2001).
Another fundamental reason for TCM's continued integration into Canadian society is its promotion of the subject's involvement in their own health care. TCM encourages the use of daily activities, such as diet and exercise, to promote good health. A major goal of TCM is maintenance of good health, which requires that the subject be proactive in promoting his or her own health. The ingredients, tools, and techniques are simple enough that a subject can use them himself. Deeper involvement in one's own healthcare also produces psychological benefits that enhance the value of doing so. Empowerment comes from control, which feeds upon itself to build even more power. As the TCM user is required to become more involved in promoting his or her own health, the benefits of doing so become more apparent and thereby serve as an impetus to continue and even increase involvement.
A third fundamental benefit of TCM is the pain relief that it produces. The clearest evidence of such are the testimonials it has inspired: "In the United States, acupuncture has its greatest success and acceptance in the treatment of musculoskeletal pain. Problems such as acute sprains and strains are most easily treated, while chronic pain patients make up the largest numbers of patients seeking acupuncture from US physicians" (Braverman 2004, n.p.). In 1997, a panel of experts assembled by the U.S. National Institutes of Health at the Consensus Development Conference analyzed studies and interviewed practitioners of acupuncture. They found, among other benefits, that acupuncture was "effective in treating painful disorders of the muscle and skeletal systems, such as fibromyalgia and tennis elbow--even more effective, in some cases, than conventional therapy" (Thompson 1997, 65). In Canada, the first recorded use of acupuncture in medical surgery outside of dental surgery took place in 1996 in Alberta. Steven Aung, trained in both Western and TCM, applied acupuncture analgesia instead of anesthetic drugs to allow a non-cancerous lump to be removed from the thigh of a patient (Walker 1996, B2). It seems that acupuncture has a proven record of pain relief within North America, including Canada.
Apart from the fundamental reasons for TCM's continued integration into Canadian society, one must also acknowledge the strong base from which TCM is developing within Canada and the momentum present in its development. This base is seen most clearly in the institutionalization of TCM. It is practised in various hospitals, is widely commercialized, and is regulated by four provinces and the federal government. It also has several self-governance and teaching organizations, including mainstream universities.
The development of this base reflects the increasing acceptance of TCM within Canadian society. Since the 1990s there have been a number of significant events marking this development. The Province of British Columbia established the self-regulating College of Acupuncturists, which was transformed into the College of Traditional Chinese Medicine Practitioners & Acupuncturists of British Columbia in 2000. The Government of Ontario passed the Traditional Chinese Medicine Act, Bill 50, regulating TCM, in 2006. The Government of Canada enacted the Natural Health Product Regulations in 2004, which encompassed herbal medicine; and in 2008, in conjunction with provincial regulatory bodies, founded the Canadian Alliance of Regulatory Bodies for Traditional Chinese Medicine Practitioners and Acupuncturists (CARB). There were two national industry associations, the Chinese Medicine and Acupuncture Association of Canada and the Canadian Society of Chinese Medicine & Acupuncture, founded in 1983 and 1994 respectively. As for schools, the International College of Traditional Chinese Medicine of Vancouver was founded in 1986, the Toronto School of Traditional Chinese Medicine in 1995, and the Alberta College of Acupuncture & Traditional Chinese Medicine in 1997. Public training programs have been available at the University of Alberta since 1991 and McMaster University since 1998.
Furthermore, as TCM has developed a base within Canada, there have been significant examples of the integration of TCM with the mainstream Canadian medical system. The awarding of the title "Doctor" to TCM practitioners in British Columbia recognizes their skill and training and made it more likely for TCM and Western medical professionals to work together as equals. The Tzu Chi Institute for Complementary and Alternative Medicine in Vancouver offered integrative care from 1998 to about 2003 out of the Vancouver General Hospital. Its patients received care from a "multidisciplinary team of practitioners representing biomedicine, chiropractic, nursing, naturopathy, acupuncture, nutrition, Traditional Chinese Medicine, massage therapy, and mind-body healing" (Mulleins et al. 2003, 586). Patients mostly used acupuncture services (Mulkins et al. 2003, 586) and nearly 90 percent rated the service as excellent (Mulkins et al. 2003, 589). Vancouver General provided space, administrative support, and a partnership grant (Ivens Mar 01, 1996). In an example that occurred in the United States, but still relative to what is happening in Canada, Tai Lahans authored Integrating Conventional and Chinese Medicine in Cancer Care: A Clinical Guide in 2003. This text combines Chinese herbal medicine with Western medicine in order to enhance and improve medical care for patients with cancer. According to a review of this book, Lahans has being able to promote the use of Chinese herbal medicine to conventional medical oncologists and to numerous hospitals. Furthermore, it is claimed that clinical research has shown her correct; the integrated approach is more effective than either modality used separately (Fratkin 2007).
Based on the above analysis, there are strong reasons to believe that the integration of TCM into Canadian society will intensify. Its fundamental values of economy, effectiveness, and self-empowerment will continue to attract users. Furthermore, it already has a strong base of institutionalization that will support greater integration. This base has developed substantially over the last twenty years, indicating that this integration presently has momentum. The fundamental values, a strong base, and existing momentum are reasons for believing in continued integration. In fact, Canada is seeing some significant examples of the deepening of this integration as practitioners have been combining TCM with Western mainstream medicine.
This demonstration of the broad integration of TCM within Canadian society gives one the opportunity to reflect upon the link between it and Canada's policy of multiculturalism. While it would be nearly impossible to show a necessary link between the two, the complementariness of the policy and this integration strongly suggests that the latter is strongly supported by the former. In return, the benefits that TCM provides Canadians are strong justification for multiculturalism.
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(1.) The article cites a study sponsored by the Canadian Health Food Association, in cooperation with the Canadian Natural Products Association and the Canadian Homeopathic Pharmaceutical Association.
(2.) The eleven schools in British Columbia are Academy Of Classical Oriental Sciences (Nelson, http://www.acos.org/), Canadian College of Acupuncture and Oriental Medicine (Victoria, http://www.ccaom.com/), Central College (New Westminster, http://centralcollege.ca), International College of Traditional Chinese Medicine of Vancouver (http://www.tcm.college.com/), Merinol College (Surrey, http://www.merinolcollege.ca), Oshio College of Acupuncture & Herbology (Victoria, http://www.oshiocollege.com/), Pacific Rim College, School of Acupuncture and Oriental Medicine (Victoria, http://www.pacificrimcollege.ca), PCU College of Holistic Medicine (Burnaby, http://www.pcucollege.ca/), Shang Hai TCM College of B.C. (Burnaby, http://www.acupuncturecollege.com/home.asp), Vancouver Beijing College of Chinese Medicine (Richmond, http://www.tcmvbc.com/), and Western Canadian Institute of TCM Practitioners (Richmond, http://www.tcm.bc.ca). The eight schools in Ontario are Acupuncture Foundation of Canada Institute (Scarborough, http://www.afcinstitute.com/), Acupuncture & Natural Healing Centre (Sarnia, http://www.acupuncturesarnia.ca/), Canadian College of Holistic Health (Richmond Hill, http://www.cchh.org/), College of Acupuncture 8c Therapeutics (Kitchener, http://www.collegeofacupuncture.com/), College of Traditional Chinese Medicine and Pharmacology Canada (Toronto, http://www.ctcmpc.com), International Academy of Traditional Chinese Medicine (Ottawa, http://www.intlacademy.com/), Ontario College of Traditional Chinese Medicine (Toronto, http://www.octcm.com/), and Toronto School of Traditional Chinese Medicine (http://www.tstcm.com/).The three schools in Alberta are Alberta College of Acupuncture & Traditional Chinese Medicine (Calgary, http://www.acatcm.com/), Calgary College of Traditional Chinese Medicine and Acupuncture (http://www.cctcma.com/), and Canadian Institute of Traditional Chinese Medicine (Calgary, http://www.citcm.com/).
(3.) Beijing University of Chinese Medicine was founded in 1956 and is one of two TCM universities included in the "211 Project" that channels resources to approximately one hundred key Chinese universities.
LLOYD SCIBAN is Assistant Professor in East Asian Studies at the University of Calgary. He studied in Taiwan for ten years. His research interests are Confucian ethics and the influence of Chinese culture in Canada. His recent publications include "Wang Yangming daode biaozhun de keguan xing" (The objectivity of Wang Yangming's standards for moral decision), Yangming xuekan (Journal of Yangming studies, Guiyang, Nov. 2012) and "Calgary's Chinese Kinship Associations: Their Role in Chinese Canadian Integration" (co-authored with Lloyd Wong), Journal of Chinese Overseas 9 (2013).
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|Publication:||Canadian Ethnic Studies Journal|
|Date:||Mar 22, 2014|
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