Philosophical and professional issues in Chinese medicine

The overall aim of this project is to investigate the conceptual and empirical validity of Chinese medicine in Australia. To this end, the work is composed of three main lines of enquiry. In the first and conceptual component of this work, Chinese medicine (CM) and Western medicine (WM) will be characterised, and the possibility that they satisfy similar fundamental attributes under the conception of a health care profession is explored. The nature and use of evidence in both CM and WM is examined, with the finding that comparisons between the two – particularly in the areas of Evidence Based Medicine (EBM) research, ‘the placebo effect’, and the nature of clinical practice – reveal complex areas of increasingly emerging similarities that are worth further consideration. Areas such as the use and overlap between the domains of quantitative and qualitative methodologies in relation to this work are also discussed. In the interventions that make up the empirical part of this work, a nationwide survey (n =655) and semi-structured interviews (n = 29) attempt to characterise the current workforce nature and attitudes of Chinese medicine practitioners and key stakeholders in Australia. CM practitioners are found to be highly educated, coming from a diversity of backgrounds, and choosing to practise in a sole or multi-practitioner private practice setting. CM practitioners value and display a number of professional attributes, in particular their continuing professional development. They are found to acknowledge a variety of disparate and inter-related forms of evidence in their practice. CM practitioners and key stakeholders are also seen here to be working within and between multiple discourses and modes of thinking regarding the body and illness. They report valuing both CM classical evidence and evidence from EBM research. While they predominantly rely on and value CM theoretical and practical structures, at the same time they are engaged in complex states of conceptual and cultural negotiation between CM and the dominant form of healthcare in Australia, WM. These findings may have implications for how we view the practice of not only CM, but also other forms of healthcare and their evaluation. Finally, the discussion attempts to situate these results within the current Australian healthcare setting and build upon the above enquiries in order to highlight areas of attention that may further enable the development of CM as a mature and relevant healthcare profession in Australia