With its focus on health maintenance and disease prevention, demand for greater knowledge and use of Traditional Chinese Medicine (TCM) throughout the world continues to increase.

Government and Regulatory

Increasing government control, legislation and regulation is being introduced to regulate the practice of Acupuncture and Chinese medicine in many countries. This provides protection to the community and also the practitioners, and serves to make TCM practices safer and more available within the community as part of a range of healthcare services. This has led to the practice in many countries of health insurance companies providing cover to members who consult accredited TCM practitioners.

Canada - Province of Alberta

Under the Health Disciplines Act, Acupuncture is a designated health profession. Legislation has been in place since 1988. A Governing Body made up of an Acupuncture Committee was established by the Minister of Health and comprises between 3 and 9 members, the majority of whom are engaged in acupuncture, with remaining members knowledgeable in respect of the practice of acupuncture. The main functions of the Committee are to govern registered acupuncturists in the public interest, review applications for registration, hear complaints and advise the Health Disciplines Board on health services to be provided by acupuncturists, standards of conduct, incompetency, qualifications and conditions of eligibility, continuing education, training programs, examinations and regulations

Australia

Victoria is the first Australian State in which regulation and registration of acupuncture and Chinese herbal medicine has occurred. Other states are in the process of following the lead of Victoria. 

In November 1996, after more than a year of thorough investigation of the practice of Traditional Chinese Medicine (acupuncture and Chinese herbal medicine), the Australian government published its findings recommending statutory-based occupational regulation of TCM as the best method of ensuring adequate public safety. Such regulation requires that TCM training be of a high standard, that the public and other health care practitioners are easily able to identify TCM practitioners who are well qualified, and that consumers have access to effective mechanisms to deal with any complaints that may arise. 

United States

In 1995 Federal legislation was enacted with the establishment of the Office of Alternative Medicine within the Office of the Director of National Institutes of Health. The purpose of the Office was stated as being to facilitate the evaluation of alternative medical treatment modalities, including acupuncture and Oriental medicine, homeopathic medicine and physical manipulation therapies. An advisory council was established together with an information clearing house to exchange information with the public about alternative medicine, provide support for research training (not fellowship support or residency training) and prepare biennial reports on its activities. 

The Social Security Act was amended to provide coverage of qualified acupuncturist services under part B of the Medicaid program to an amount not exceeding 65% of the scheduled fee for that service if it were performed by a physician. The US Code has also been amended to provide coverage of such services under the Federal Employees Health Benefits Program. Nurse midwife acupuncturists are also included. The amendments took effect January 1, 1997. 

At the US Sate-level there is considerable regulation of the practice of acupuncture and herbal medicine. Twenty-seven US states have enacted specific legislation for the practice of acupuncture. Many of these acts deal also with the broader concept of `Oriental Medicine'. A further four states permit the practice of acupuncture under the supervision of a medical doctor. Four states, California, Nevada, New Mexico and New York represent different styles of regulations.

For a more detailed description of the practice and efficacy of acupuncture in the United States you may wish to visit the US National Institutes of Health's National Center for Complementary and Alternative Medicine who provide a fact sheet on acupuncture. 

Hong Kong

In 1989 the Hong Kong Government appointed a working party to review and make recommendations on the use and practice of TCM. In its October 1994 report, the working party said that `the spirit of self-regulation' had informed its proposals. All TCM practitioners were to be registered eventually, but in a first stage, a preparatory committee was to draw up a list of those who had been in practice for a specified period and to advise on legislation, which would include the establishment of a statutory body. This is now in place and registration is proceeding. The Chinese Medicine Ordinance now dictates that all Chinese medicine practitioners in Hong Kong must be registered before they can practice. The Chinese Medicine Council of HK has considerable information available on the regulation of Chinese Medicine Practitioners - click here for details.

China

The principal governing body for TCM is the State Administration of Traditional Chinese Medicine (SATCM). The production, sale and distribution of herbal prescriptions in China is managed by the Ministry of Health. There are three levels of competency identified in TCM:

1. Basic: Fundamental training is offered through a 2 year apprenticeship. Apprentices proceed to practice as "barefoot doctors" in rural China where access to medical care is minimal 

2. Intermediate/Paramedical: Training programs of 3-4 years are offered through post-secondary institutions

3. Tertiary/Professional: Training and formal education through an intensive 5-7 year university level program

All practitioners must be licensed and there are detailed regulations governing the establishment of a medical practice in TCM. Licensing or approval is granted at a local county level by the Department of Health and Traditional Chinese Medicine or by the local municipal government.