TCM and Acupuncture in Ontario

Comments on Bill 50 regarding TCM and Acupuncture regulatory process in Ontario

At the public hearings on the Bill 50, I had some comments. They have been submitted to the Standing Committee on Social Policy on October 31, 2006:

DAN MICU presentation

The Chair: I would now invite our next presenter, Mr. Dan Micu. Please come forward, Mr. Micu. As you've seen, there's 10 minutes in which to make your presentation. Please be seated, and your time begins now.

Mr. Dan Micu: Chairman, members of government, members of Parliament, first of all, I would like to thank you all for the opportunity you give us to have public hearings on Bill 50. I fully support Bill 50, and I'm very sorry that some of my colleagues prefer to oppose the bill instead of proposing specific, objective and positive changes to that. I would think that a more diplomatic approach would move ahead the regulatory process much faster. Also, I'm not so happy, and I'm very surprised, about the approach of some of the other health professionals that do not consider at all the benefits of a traditional Chinese medicine regulatory process.

I would like to thank you all, members of government, honourable members of Parliament, for the mature and responsible manner in analyzing the issues of this bill. I am convinced that Bill 50 will pass, in the benefit of the public. However, I would respectfully suggest taking into consideration, if possible, a few opportunities for improvements and comments.

About myself: I have a bachelor of science in engineering. I graduated with a quality assurance diploma at Seneca College, Toronto; first traditional Chinese medicine studies in Romania between 1991 and 1993 for 500 hours. Also, I graduated with more than 2,400 hours in the acupuncture diploma program at the Toronto School of Traditional Chinese Medicine. I've been a member of the Canadian Society of Traditional Chinese Medicine and Acupuncture since 2003, and a member of the American Society for Quality organization since 1996. I have had a private acupuncture and tuina massage practice in Toronto since 2003.

Opportunity for improvement number 1: In order to clarify the scope of practice and give a more specific definition of traditional Chinese medicine, I would suggest that section 3, scope of practice, be amended as follows:

"The practice of traditional Chinese medicine is the assessment of physical or mental condition of an individual through traditional Chinese medicine techniques and treatment to promote, maintain or restore health using one or more of the four primary therapies" -- acupuncture and moxibustion; traditional Chinese manipulative therapy, tuina, and rehabilitation exercises, lian gong or dao yin; traditional Chinese energy control therapy, qi gong, and tai ji quan; and prescribing traditional Chinese medicinal formulas and Chinese food cure recipes.

I included mental condition above because traditional Chinese medicine has a holistic perspective, and many physical disorders have a mental or emotional root cause and vice versa.

Opportunity for improvement number 2: It would be necessary that a new section be added after section 3 as follows:

"Authorized acts

"In the course of engaging in the practice of traditional Chinese medicine, a member is authorized, subject to the terms, conditions and limitations imposed on his or her certificate of registration, to perform the following": communicating a diagnosis; performing a procedure on tissue below the dermis; prescribing, dispensing, selling or compounding a traditional Chinese drug or related natural health products. There are five points here.

Opportunity for improvement number 3: An addition to the definition paragraph of section 7, "Restricted titles," would be necessary as follows:

"(i) `traditional Chinese medicine practitioner' is the title reserved for the exclusive use of registrants of the college.

"(ii) `acupuncturist' is reserved for those members of the college who are not qualified to use `traditional Chinese medicine practitioner' as their training is only in acupuncture."

Number (iii), "abbreviation," remains the same.

Comments:

(1) Minimum standard for acupuncture: Practising acupuncture by other health care professions cannot be stopped or restrained. It would be necessary that a minimum standard of practising acupuncture be recommended by the college to the other colleges as they are defined in the Regulated Health Professions Act, schedule 1, as applicable. Responsibility would remain under the other colleges and ministry to adopt such a minimum standard for practising acupuncture by these colleges' members. The public will be aware of that and will proceed consequently.

Ultimately, we should be interested that more and more health professionals use acupuncture at or above the minimum standard. This is the best educational exercise in widely promoting acupuncture and TCM for the benefit of the public. The second step is going to be done by those practitioners who want to improve their knowledge and discover the effectiveness of traditional Chinese medicine.

Ultimately, our aim is to develop sooner or later an integrative medicine, together with other health professionals, for the benefit of the public as well. This is just because most of us TCM practitioners consider that traditional Chinese medicine can be a complementary medicine rather than an alternative one. I have to say that, although for many acute or chronic disorders, TCM remains as the last resort. However, I am convinced and I strongly believe that TCM can provide the highest, most efficient -- I underline "most efficient" -- safe and good-quality standard for acupuncture.

(2) The grandfathering issue should be left at the college's discretion for the transition period.

(3) The most important thing for traditional Chinese medicine's future in Ontario is that in the college of traditional Chinese medicine be appointed and involved task forces composed of objective individuals with expertise and experience in traditional Chinese medicine, health professions regulation and quality assurance to provide advice and to help in handling specific and difficult issues.

Thank you.

The Chair: Thank you, Mr. Micu. About a minute per side, beginning with Mr. Arnott.

Mr. Arnott: Thank you very much for your presentation. On the last page, point 2, you said grandfathering should be left to the college's discretion for the transition period. Would you care to offer the committee your personal opinion as to how that issue should be handled?

Mr. Micu: You know, actually, we cannot set aside the fact that a lot of acupuncture and traditional Chinese medicine practitioners do that for many, many years, 10 or 20 years. But the college is supposed to have a body of knowledge, a minimum body of knowledge, so minimum conditions and criteria. Following an interview to decide, and following -- actually, according to their credentials and to prove that they did, for example, practise acupuncture for 10 or 20 years; I don't know how many years is the best figure here, and from case to case to provide the right to --

The Chair: Thank you, Mr. Arnott. Ms. Martel?

Ms. Martel: Thank you for your presentation today. I want to focus on minimum standards. You've talked about a minimum standard being recommended, and I'm assuming recommended by the TCM college to other --

Mr. Micu: Yes, by the college.

Ms. Martel: Yes, to other colleges. But it would be your view that the other colleges monitor that or regulate that minimum standard, not the TCM college?

Mr. Micu: Right.

Ms. Martel: You said right at the start, "Practising acupuncture by other health care professions cannot be stopped or restrained." Do you think that all the 23 regulated health professions should have access to practising acupuncture?

Mr. Micu: My personal opinion is not all. For example, a speech therapist: I don't know how much it can help him or her to practise acupuncture. I would leave this for more thorough analysis to the college.

Ms. Martel: The TCM college?

Mr. Micu: The TCM college.

The Chair: Thank you, Ms. Martel. To the government side. Mr. Fonseca.

Mr. Peter Fonseca (Mississauga East): Mr. Micu, thank you very much for your presentation. It was very refreshing and open the way that you spoke to working in collaboration with others in partnership. This is what we want to see with the other regulated health professions. We've heard from the chiropractors, the physiotherapists and others here in terms of how they use acupuncture within their practices.

I'd like to hear from you: As the college is formed, how do you see the college working with the other regulated health professions in partnership towards moving acupuncture forward in Ontario?

Mr. Micu: If I would decide that, I would form a consultative committee. In two days here, we heard different opinions. If for six months or for one year, all members of this body would work together, for sure it would come up with something much better than we can decide for now.

The Chair: Thank you, Mr. Fonseca. Thank you to you as well, Mr. Micu, for your presence and presentation today.

For more details please see:
http://www.ontla.on.ca/hansard/committee_debates/38_parl/session2/SocialPol/SP033.htm#P293_65191