Lab Tests: An Essential Tool For Herbalists

By Jake Paul Fratkin, OMD, LAc

Should herbalists be using lab tests? This question should actually be divided into several questions. First, what level of Western medical training is appropriate for the TCM herbalist? Second, if the patient does not come with important lab tests, should we be ordering them? And if so, which ones?

While skilled acupuncturists might go about their work without deeper medical training, relying on their hands as their chief diagnostic tool, herbalists are more often treating patients with significant medical conditions and history. Certainly, there are many TCM herbalists who prefer the classical approach, that despite (or in ignorance of) medical diagnosis, they will prescribe herbs based on pulse, tongue and history alone, and of course get good results. My feeling, however, is that without knowledge of their medical diagnosis, they are working in the dark. They cannot make accurate predictions as to the course of the illness. They may be missing something quite important that would affect their own prescribing, or more importantly, the need for medical intervention.

How much Western medical training is necessary for the American TCM herbalist? Here, I defer to the experience of our colleagues in China. My advanced training was in China, and the herbalists there go through two years of medical sciences prior to training in TCM. Although not to the degree of Western medical doctors, in the TCM urban hospitals doctors will often order blood tests and imaging to diagnose infections, autoimmune illness, organ involvement and more. They also use those tests to monitor improvement. In America, training in medical sciences and diagnosis is reaching good levels at certain TCM schools on the west coast, but most of the schools offer sub-standard training for a Master's degree health practitioner program.

We need to accept the fact that TCM practitioners in the field are primary care providers for many of their patients. This will only increase as health insurance rates skyrocket. Burdened with exorbitantly high deductibles, people will use TCM practitioners for interventions and therapies that offer real improvement early on.

As primary care providers, how many of us can say that we have the medical level of a nurse practitioner, a physician's assistant, a naturopath, or a physical therapist? The future will see medical doctors gravitating towards specializations, while NP, PA and PTs will become the primary care givers and gatekeepers. This should be our role as well, and we will need to know what and when to refer. My argument leads us to consider medical training that equals that of a nurse practitioner or physician's assistant. This should be given by bona-fide health science centers, not casually as is currently offered in acupuncture schools.

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