The following quotes demonstrate this:. We practice both Chinese and Western medicine together. We work in a hospital. The main difference in terms of conditions treated between the two countries was related to being able to treat internal conditions in China, whereas in New Zealand, treatment was sought more for pain management purposes.
The following quotes convey this:. In China, besides pain we also treat internal diseases. We treat heart disease, digestive conditions and all kinds of diseases. They come for pain related problems.
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Like neck pain and shoulder pain, lower back pain and ankle pain. This theme involved practitioners discussing the ethnic diversity of the patients they treated in New Zealand. It highlighted that individuals from a number of different ethnic groups were seeking TCM based treatment.
Two practitioners mentioned that in China it was common practice to treat children compared to New Zealand, where patients were predominately adults. One practitioner did give an account of treating Chinese children in New Zealand, though she mentioned that she did not treat European children in New Zealand. A number of practitioners discussed how the majority of their patients were female regardless of the country they were practising in.
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This theme involved practitioners discussing how TCM knowledge in China is passed down from each generation. Hence, Chinese people have an understanding of the underlying components of TCM philosophy in contrast to non-Chinese individuals, such as New Zealand Europeans, who need to be educated about the philosophical underpinnings of TCM. In the following quotes, a number of practitioners discussed how some Chinese individuals were more likely to seek TCM treatment as a first choice of treatment compared to New Zealand Europeans, who appeared to use TCM as an alternative form of treatment after having consulted a Western medicine healthcare practitioner.
In most cases this was a general practitioner GP. The following quotes illustrate this:. But here in New Zealand , Western people would not choose Chinese medicine as their first treatment choice. Some have already got a diagnosis from their GP and they come to our clinic for alternative treatment. I think for Chinese people, because they know Chinese medicine well, if they have any pain related problem, going to the acupuncturist will be their first option. But for Kiwi people many will be referred to an acupuncturist.
Many of the people who come here have already seen an orthopedic surgeon or two or three physicians. Compared to Chinese herbal medicine, acupuncture appeared to be an acceptable and more utilised form of treatment for New Zealand European and other non-Chinese patients in New Zealand. Also discussed was the observation that an individual was more likely to seek acupuncture-based treatment in the future if they had a successful experience of their initial acupuncture treatment. This study was designed to identify differences associated with being a TCM practitioner in New Zealand compared to China.
The main differences were associated with how TCM treatment predominately acupuncture was viewed and utilised by the larger New Zealand population. CAM treatments in general, including TCM treatment are viewed by the general New Zealand population as alternative forms of healthcare treatment. There were also differences in the type of conditions treated between the two countries, as well demographic differences relating to the type of patients treated. Western medicine and TCM are the two mainstream medical practices used in China.
TCM practitioners can also prescribe certain Western medicine drug treatments for a number of conditions. One main reason for this is that biomedicine is part of the TCM degree structure in China.
TCM practitioners work in a number of medical settings, including hospitals and clinics. In comparison, TCM practitioners in New Zealand are viewed by most individuals as being alternative healthcare practitioners. In New Zealand, TCM practitioners predominantly work in their own private practice or as an employee in a TCM-based clinic which generally offers acupuncture, Chinese herbal medicine and Chinese massage treatment.
In some cases, TCM practitioners work exclusively as acupuncturists. The TCM practitioners in the present study conveyed that the majority of their non-Chinese patients sought TCM treatment as an alternative form of treatment after they had consulted with another healthcare practitioner, predominantly a general practitioner GP. A number of practitioners discussed how the majority of patients they had treated in New Zealand sought treatment for pain related complaints and conditions ie, muscular problems related to both the upper and lower body.
A New Zealand study that examined both the demographic profile and the complaints and conditions for which patients sought treatment at a TCM clinic, reported that patients tended to seek treatment for pain management purposes more than any other complaint or condition. Research indicates that individuals tend to seek CAM treatment, such as acupuncture, when conventional Western medicine cannot help treat or manage their condition.
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The practitioners in the present study gave accounts of how a number of their non-Chinese patients seek treatment for pain-related complaints and conditions. This may be associated with the fact that since the s in New Zealand, the Accident Compensation Corporation ACC has funded acupuncture treatment for injury-related conditions. ACC fund acupuncture treatment for these conditions based on the efficacy of acupuncture in the management of musculoskeletal pain.
In , acupuncturists were registered as ACC treatment providers. In , ACC spent almost 27 million dollars funding acupuncture treatment. Almost 20 million of this was spent in the Auckland region. In , ACC received 58, claims that resulted in acupuncture treatment. The five most common conditions seen by ACC-registered acupuncturists are: lumbar sprain, sprain of shoulder and upper arm, neck sprain, ankle sprain and thoracic sprain.
A number of practitioners discussed how knowledge of TCM is generationally passed down in China, resulting in TCM being a popular form of treatment for many Chinese people regardless of age. This knowledge of TCM may have appeared to extend to Chinese individuals living in New Zealand, as accounts were given where practitioners treated Chinese children but not New Zealand European children.
Age differences in relation to patients treated in New Zealand were one of the main demographic differences that were identified in the present study. In relation to ethnicity and TCM use, the results of the present study indicate that some TCM practitioners have encountered some of the ethnic diversity that reflects the current New Zealand population.
Auckland also hosts the largest Chinese population in the country. A growing demand for TCM especially acupuncture may also be influenced by previous experience of acupuncture. For example, one participant discussed how non-Chinese individuals who have had a successful initial experience of acupuncture treatment are more likely to seek acupuncture in the future for similar conditions.
In line with this, one Auckland-based TCM clinic reported that almost one half of all new patients enrolled during a fourth-month period identified as being New Zealand European. The one demographic similarity between the two countries was related to gender. Practitioners in the present study gave accounts of treating more female patients compared to male patients across both countries.
Both New Zealand and international data indicate that compared to males, females are more likely to seek CAM and other healthcare treatment.
A major strength of this study is that a qualitative methodology using an interview approach was employed. This allowed practitioners to discuss in detail their views and experiences. A potential limitation of the study is that a small number of TCM practitioners were interviewed, all of whom practised in a major city in New Zealand. TCM practitioners practising in other parts of New Zealand may have encountered other differences; likewise, the same could be said about their experience of TCM practice in China.
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Hence, generalising findings to the larger TCM practitioner population in both New Zealand and in China should be done with caution. In regard to our sample, it is possible that participants may have felt obligated to participate in the present study as they were all predominately current staff members at NZCCM. However, the Participant Information Sheet did state that participation was voluntary and that participation or non-participation would not influence their employment status.
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