Can West meet East?

Yvonne Lo 盧宛聰

HK Pract 2007;29:289-290

It always intrigues me when a patient comes in and attributes his symptom or complaint to something being deficient or excessive in the body system in traditional Chinese medicine terms. Being nurtured with a Western medicine background, where almost all theories are scientific and evidence-based, I am often lost in words trying to respond to these patients with reference to the traditional Chinese medicine context.

Research has shown that cultural factors do have influences on patients' concepts of health, their health care attitudes and health seeking behaviour.^1,2 Chinese patients do have their own perceptions of self, health and illness.^3,4 The nature, the course and the outcome of a medical encounter are often influenced by cultural expectations.^5,6 Patients always wish their physicians to be sensitive to their cultural beliefs and that they can be more knowledgeable about complementary and alternative medicine in our part of the world.⁷ Studies have shown that Hong Kong Chinese people do have their own views, beliefs and attitudes towards traditional Chinese medicine as well as Western medicine and probably, a majority of them would try to explain and understand their illnesses by way of their own ethno-specific traditional medical concepts instead of according to Western medical principles.^8,9 However, most health professionals in Hong Kong are trained in the Western medical education system without Chinese traditional concepts of health and illness. Discrepancies often exist between health professionals' and Chinese patients' perceptions of health, and their evaluation of the quality of care provided by Western doctors will become difficult. However, traditional Chinese medicine practitioners are more likely to explain the nature of the illness to their patients than their Western counterparts and similarities of ideas between the traditional Chinese medicine practitioners and their patients in the concepts of health and disease causation might facilitate better doctor-patient communications.¹⁰

Western medicine has all along been the mainstream of health care in Hong Kong, but traditional Chinese medicine is also commonly used by the local population.¹¹ However the development of traditional Chinese medicine did not receive much recognition until after the return of sovereignty of Hong Kong to China in 1997.¹² From the local Thematic Household Survey in 2002, it was found that the higher socioeconomic group of the Hong Kong population was emerging as a new class of traditional Chinese medicine users apart from the usual principal users comprising women, the elderly, patients with chronic diseases and people in poor health. It was also found that a higher educational level was associated with a preference for and regular use of traditional Chinese medicine.¹³ To ponder, would there be a need for Western trained health professionals to be sensitive to their Chinese patients' conceptualization of their illness experience which, to a large extent, are culturally determined and become acquainted with the philosophy and principles of traditional Chinese medicine?

In the context of traditional Chinese medicine, functional discord among mutually dependent vital organs will lead to symptoms and yet these organs do not directly correspond to the anatomical positions or the physiological functions within the Western medicine context. Without understanding the mechanisms underlying traditional Chinese medicine, misconception of their patients' ideas among Western trained doctors will exist and also difficulty for these doctors in accepting this form of medicine.

The Hong Kong Practitioner is pleased to present a series of six articles on traditional Chinese medicine and the philosophies behind. In this issue, we start with the first article - the zang kidney, which will cover a wide range of concepts.