[I sent this to "Acupuncture Today," but they don't really do Letters to the Editor, so I decided to post it here...]
I've been going along practicing small town Chinese medicine for 26 years, and growing more and more dismayed at my profession's agenda and trajectory. My dismay is associated with the trends illustrated by two articles in this month's (May 2026) Acupuncture Today: the first claims that using automated online scheduling is the way forward for acupuncturists within the VA; the second approvingly cites "the latest thing from China regarding the constitution," and its claims that "By clarifying the relationship between constitution, disease, and pattern differentiation, the standard strengthens professional credibility, supports research, and enhances patient-centered treatment."
I can't tell you how much I think these are the wrong things for our profession to hold onto; further, that they are exactly the wrong direction for us to move in. Both are rooted in surrender to the biases and expectations of the intellectually unbalanced West, and if we have ANYTHING to offer at this moment in human history, it is to continue to steadfastly insist that, "No, balance of mind, body and spirit is more important than any trend of language, philosophy, politics or economy." This takes confidence, even stubbornness, but without holding our ground we just make ourselves into another "auxiliary" branch of Western medicine -- incomplete, deficient, and forever subservient to the allopathic approach.
For starters, TCM itself was such a ceding of ground to the West -- an attempt to make Chinese medicine more palatable to Western science and more consistent for its varied practitioners. News flash -- it didn't work. The language of TCM is still too subjective and too dependent on context for the West's intellectuals to ever approve. AND the outcomes are less successful than the outcomes derived from TCM's organically-grown antecedent, Classical Chinese medicine. So just as in some Bronte sisters novel, we subjugate and debase ourselves and still don't get the attention of the lords and ladies. Now, in our desperate (and somewhat pathetic) efforts to ingratiate ourselves with gatekeepers, we volunteer to give up autonomy by pushing forward with robotic scheduling? Will you next suggest that we allow AI to help us with treatment planning and pattern differential? You know, so the rich and powerful kids on the playground will play with us? THEY WON'T, no matter what we do -- we don't just speak a different language -- we pay attention to a different understanding of existence, and there's no getting around that basic fact. If we had any security, confidence or professional pride, we would continue to stay our course, providing excellent alternative medical care, and continuing to let people come to us in their own time, whether as individuals or as part of larger groups like the VA (which very much DO recognize our value).
To be clear: I have been a VA Care in the Community provider for about 10 years; I participated in the Medicare study that resulted in acupuncture for LBP becoming a payable procedure; and I have accepted Workers' Comp and No-Fault insurance since the beginning of my career (in 2000). I am not suggesting that we remain peacefully in our hermetic caves, waiting for patients to fall from the skies, but I AM suggesting that our political and cultural lobbying efforts, which were looking promising for a while, have suddenly taken a foolish and fearful path which completely overlooks our actual power. Our power doesn't lie in aping Western medicine, speaking their language and essentially fulfilling their ideas about "dry needling." Our power lies in preserving and practicing the oldest continuous form of aboriginal medicine in the world, repeatedly demonstrating that it is safe and effective in situations where science and the intellect alone are not, and repeatedly seeking new arenas (like pandemic medicine) where our approach is plainly superior to Western approaches. Yes, they have all the money and all the power, but they also are making blunder after blunder after blunder by ALWAYS giving science the last word and ALWAYS choosing human-made, two dimensional symbols like numbers and letters rather than engaging with the complexity of the three dimensional world that we actually inhabit and that our medicine attempts to understand.
Most controversially for the intentions of this letter, native-born Chinese practitioners are the LAST people we should be looking to for advice about the direction of our medicine. Given the sometimes murderous gyrations of their nation since 1949, the only certain thing that we can say about such providers is that they are survivors. I am big on survival myself, but surely we can aspire to something higher than simply surviving a despotic system and trying to guarantee ourselves, through political and bureaucratic means, a certain number of crumbs from the table? Acupuncture is engaged with eternal truths which will reasonably be expressed in different ways, with different strengths and weaknesses, by different cultures. American, or at least Western, approaches to acupuncture have little to offer in terms of tradition, but we are very ingenious and energetic, and we don't like taking "No" for an answer. Possibly we'd be better off leaning into our cultural strengths rather than trying to ape a different culture as we continue to work to create a bona fide American style of acupuncture. However, this doesn't mean CHANGING ACUPUNCTURE -- although Americans are seen by the world as being naive, brash and reckless, we don't have to extend our tendency to disrespect to the actual practice and philosophy of the medicine. Indeed, it is a larger betrayal to surrender to AI and the scientific method than it is to question, even to challenge, practitioners from our medicine's native land.
Specialization; appropriate insurance reimbursement; standardized education. These are all reasonable, logical goals to strive toward, and we will always lose if we only aim at reasonable, logical goals. The scientific, binary West is better at logic than the philosophical, three dimensional East is; is pursuing logic at all costs; and fealty to logic is what is taking the West (and the rest of the world, which has largely bought in) straight off the edge of the cliff we all find ourselves upon.
Not only CAN our community do better; it MUST do better. Most of humanity agrees that we're on the wrong trajectory, and we practitioners of Chinese medicine are all about trajectories -- that's our expertise! Yes, they're fuzzy sometimes and meander when you want them to go in a straight line, but if there is anything to our method it is rooted in understanding trajectories. The trajectory of American acupuncture is currently toward an existence as third class medical factotums who can speak medicalese real good, but are no more effective or any different than the physicians we are aping, because we will merely be practicing a hamstrung, primitive and bastardized version of what physicians already endorse. And we will be mocked and blamed when our hamstrung, primitive and bastardized techniques don't work very well.
Happy to discuss it more, if anyone is listening, but finally wanted to get it off my chest.
Thanks for your time.
Trey Casimir M.S., L.Ac.
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