Eastern Medicine in the Western Ward Integrative Medicine at Its Best
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feature Eastern medicine in the Western ward Integrative medicine at its best The Shiram unit at Assaf Harofeh Hospital. By Ehud Udi Tal additional wards, benefiting thousands of people and proving itself to be of great value within the modern hospital system. True integrative medicine takes complementary medicine to Each hospital applies its own unique the next level. As practitioners we talk about it, conceptualise financial system. In one of the hospitals, the research fund pays for part of the cost, and it, wonder whether it will work in the field alongside our current the rest is subsidised by the hospital itself. In medical system, in the Western ward, and in the Western world. other hospitals, the program is partly funded by the national health care scheme or by private health insurance and the rest of the O MAKE THIS sort of program work, cost is covered by patient out-of-pocket gap a sound financial model is impera- payment. It is favourable to have a variety in Ttive and sufficient scientific proof is the financial models on offer, as it ensures paramount for its potential to be realised the survival of the program as a whole. and fully adapted into the Western system. The toughest challenge for practitioners While we sit here and ponder the idea, three working in the hospital system is to discern advanced western public hospitals have been what aspect of traditional Chinese medicine successfully integrating Chinese medicine, is most applicable within the hospital setting. naturopathy, hypnotherapy, reflexology, tra- Factors such as time constraints and limited ditional Chinese dietary advice, qigong and clinical follow-ups need to be considered. taichi into their cutting-edge Western medi- The integrative medical team needs to cal system. scrutinise the different Chinese medicine This work is supported by evidence-based methods for given conditions and ascertain medicine, with ongoing and continuing which techniques provide the greatest health n Ehud Udi Tal has 21 research, using real cases and accumulated benefits for patients in the shortest possible years of clinical expe- data that is derived directly from research time, while at the same time considering rience, specialising conducted within the integrative program the hospital’s needs. At times, all these in Remedial Physical at the three hospitals I have visited this factors need to be considered within a single Therapy. and is a doctor year. Treatment protocols and approaches treatment. of Traditional Chinese are continuously modified and adapted to Record keeping is imperative for accurate Medicine (acupuncture further enhance clinical outcomes. Some follow-up, accountability, safety, and for and herbs) based in truly impressive clinical results see the successful development of the program. Melbourne. program develop further and expand into Tongue images, pulse dynamics, and full The Lantern 45 feature Chinese and Western diagnosis are noted. All sit together with the patient to discuss acupuncture techniques and clinical results treatment options, using both methods, in are meticulously recorded in a database so order to ascertain the best way forward. Head physician in Israel’s The improvement ‘‘in life quality for that an accurate critique can be drawn up Routine daily ward rounds and inpatient based on the VAS scale. This enables a full care are conducted, catering for orthopaedic patients with evaluation of a treatment immediately after paediatric oncology patients, IBS patients, integrative medicine is the session, or after a series of sessions, hyperemesis patients and routine treatments undeniable. Western depending on the particular circumstance. within the emergency department. physicians who care The team discusses clinical results and The centre is involved in the final training for their patients will processes on a weekly basis to assess the stages for senior TCM practitioners, providing do what is needed treatment’s efficacy. Clinical approaches are them with a unique internship program that to improve clinical modified in accordance with studies and specialises in the field of integrative medicine, outcomes in any way data collected over time. The more successful internal medicine and orthopaedics within approaches are further developed, while the the hospital setting. As recognised trainers possible; it is this slower or less efficacious techniques are left of Dr Tan’s Balancing Method, acupuncture attitude that enables aside and may be reserved for clinical cases students further benefit from this expertise. integrative medicine with obscure presentations, where other Ongoing research is carried out at the to enter the hospital methods may fall short of their expected hospital, providing successful treatments for system, and it is this outcomes. In this way the team enhances acute neck and lower back injuries caused approach that keeps clinical results in the short term, and ensures primarily by road accidents. integrative medicine further program development in the long At the Ichilov Hospital in Tel Aviv, a head alive within the run. As with all medical professionals, the physician who is versed in both traditional methods and conventional Western medicine hospital system. integrative medical team meets prior to every shift to ensure that practitioner hand- leads the integrative medical team. The team – Dr Shachar Lev-Ari, over protocols are observed. This ensures in this hospital is stationed among the other Head physician in Israel’s leading Tel-Aviv hospital clinical efficiency, continuity, safety and wards. There are up to 20 acupuncturists. accountability. These practitioners are traditionally trained The Shiram unit at Assaf Harofeh Hospital professionals who observe traditional in Israel, just east of Tel Aviv, was first Chinese medicine protocols and practise established in 1991 as an outpatient clinic with all its trimmings within the western on hospital grounds. It was the first clinic setting. The team include Tui-Na of its kind to offer Chinese medicine as practitioners, hypnotherapists, psychologists, an integral part of the hospital’s medical chiropractors, qigong or taichi instructors program. It is run by Adi Fromm, head of and diet therapists of Eastern and Western integrated medical services and head of the paradigms. These highly experienced staff TCM department at the Reidman College. discuss cases openly and receive input and The Shiram Centre carries out around ideas from their fellow practitioners. 10,000 treatments a year, using modalities I sat in a conference room with the inte- such as tuina, Chinese herbal medicine and grative medical team and witnessed the acupuncture. strong level of co-operation, their sincerity Western physicians at the hospital co- and desire to provide the highest level of ordinate and refer patients directly to the care. This devotion drives the operation clinic. Acupuncture is also carried out in the and makes it the success that it has become. inpatient wards and the ER department. Seasoned practitioners must be able to accept Guy Polak, chairman of Israel’s TCM the need to learn from one another, at times Association and head of the Chinese having to put their own ideas and prejudices Medicine division at the Shiram Integrated aside, and accept methods that have proven Medical Department, describes the four successful. At this fast-paced forum, decisions major pillars of the program at the Assaf are taken quickly and are primarily based on Harofeh Hospital that make it so unique. successes. There is no place for ego, and no The outpatient unit provides personalised time for heroes; the team functions as one. treatments in private rooms. There is a All attempts are made to achieve the best complete medical integration, where both a possible result for the sake of the patients and Western and a Chinese medicine physician for the program as a whole. 46 Vol:12-3 feature Successful research coming out of the after treatment, making the procedure more wards provides much weight for integrative tolerable for patients, improving patient medicine and further validates the team’s compliance, leading to more successful work. In this way integrative medicine outcomes. I spoke to one patient who has expands its scope within the hospital system. a friend on the ward undertaking the same Scientific research data enables Chinese treatment. While his friend was initially medicine practitioners to gain further uninterested in acupuncture, he quickly respect with their Western colleagues, slowly came on board once he realised the positive encouraging more Western physicians to impact acupuncture had on his friend. Now accept, take on, and request assistance from they both make use of the acupuncture the integrative medical team for their patients. offered at the oncology ward. Rehab scalp acupuncture Chinese medicine has proven itself especially At the Bnai Zion Hospital in Haifa, Israel, at Bnei-Zion Hospital. with those vague Western conditions such as Japanese-style scalp acupuncture is used stool incontinence, IBS, drug-sensitive pain successfully to treat stroke patients in the relief—those very conditions that Western outpatient ward, alongside physio and medicine tends to lack in. occupational therapy. This combination of Dr Shachar Lev-Ari, director of the approaches has provided great advantages to Integrative Medicine Research Laboratory at patient recovery, speeding up patient release the Tel Aviv Sourasky Medical Center, said: times, a very favourable outcome for busy “The improvement in life quality