Articles by Alex Tatevian
Medicine of the Fourth Kind
by Alex Tatevian, DA
Southern New England Health Care Review; 2000; Vol. 10, Issue 3.
Conventional medicine developed from three medical milestones:
1) Herbs, the administration of substances that developed into
2) the knife, which evolved into surgery,
3) the word, which gave us psychiatry.
These are used alone and in combinations to provide the most
effective medical treatment. They mix, compete, interact, and
invade each other's domain. For example, traditionally allopathic
coronary disease now utilizes surgical applications, and H-2 Blockers
and antibiotics deprive surgeons from gastrectomys.
Acupuncture does not fit into any of these three categories. Even
herbology makes more sense than acupuncture for the western
scientific mind. Medical professionals have to overcome intellectual
and professional barriers to accept acupuncture as medicine of the
fourth kind and not just as another supplementary technique.
There are basically three models of integration: multidisciplinary,
interdisciplinary, and transdisciplinary.
Multidisciplinary describes the relationship between conventional
and unconventional practitioners and their patients. There is no
formal communication between practitioners to coordinate care.
Patients are shy to tell their physicians that they go to an
acupuncturist, and apologize to their acupuncturists that they
see chiropractors, and so on. The patient takes the initiative
and control, yet his approach to medical treatment is often trial and error.
The interdisciplinary approach to integrative medicine has become
the recent trend in Rhode Island. More and more physicians feel secure
to refer their patients to a licensed acupuncturist, a last resort
when allopathic medicine has exhausted its options. Physicians have had
little confidence in the efficacy of acupuncture, and
when a positive outcome is achieved, continue the referral practice.
There is no exchange of medical records, no follow up notes, and most
importantly, no coordination of care.
The transdisciplinary approach is what I see as the ideal model of healthcare
integration for acupuncture when it has evolved into a new entity.
The best features of a trandisciplinary model are synchronized,
coordinated, and optimazed care for the patient. The implementation
of different therapies must be synchronized into a logical combination
to effect the best possible medical outcome. To avoid poor and excessive
treatment regimes, there must be coherent protocols. It is not an easy model
to achieve, and we are a good distance away from actualizing it.
Traditionally associated with China, Japan, and Korea, acupuncture
is incorporated into medical practice in Europe. Acupuncture was
introduced in Europe by European physicians who brought it from
Far Eastern colonies. That mode of introduction made it credible.
The first known European acupuncture publication was dated
1671 and was published in Holland. Modern medicine as we know it
today did not exist yet, and there were 300 years of parallel
development, interaction, and scientific scrutiny.
There are similarities and differences in the contexts of European and
Chinese acupuncture. The similarity is that there is close communication
and contribution between acupuncturists practicing in Europe and China.
European professional's practice based on the principles of Traditional
Chinese Medicine. Chinese practitioners promptly accommodate and incorporate
new European techniques such as electropuncture and concepts like
The difference is that European acupuncture coexists with highly advanced,
state-of-the-art modern medicine, and Chinese acupuncture does not.
Acupuncture in China quite often aims to replace conventional medicine to
fill the gaps and deficits in healthcare.
The Next Step
Overloaded with sophisticated hardware, the medical field is starving
without new fundamental ideas. The overwhelming advance of medical
technology made possible practical realization of theoretical concepts
developed by the previous generations of physicians and scientists.
The medical field turned into a trillion-dollar
industry and reached the point of saturation. Breathtaking achievements
of modern medicine do not impress the public any more. Medicine has
spent the last 100 years making people healthcare dependant.
Now we are trying to reverse that. Holistic medicine and prevention
became the most recent medical paradigm and political statement.
But so far it has not changed the philosophy of medical intervention.
It may degrade into another round of making generally healthy people
health care dependant with "all natural" supplements, life-style drugs and pointless
Reliable statistical analyses are few as acupuncture in America is
still too young. The marriage of classical acupuncture with modern
technology opens new horizons for study. The problem with double blind
studies can be resolved by replacing a traditional acupuncture needle
with an infrared low energy laser. Modern scientific investigation of
acupuncture points and meridians proved their actual existence, and
has produced perhaps the only new fundamental concept formulated in
the biomedical field in the last 60 years. If further research
supports the idea of acupuncture channels as a new integrative system,
it will be as major as the discovery of the nervous system.
Alex Tatevian, DA
New England Health Care Review; 2000; Vol. 10, Issue 3.
This page last updated: 14-Mar-2015