With all the carnage in Detroit, I am not even certain that anyone can purchase a new GMC truck anymore, but I have always appreciated their unique selling proposition (USP) or company slogan, which is, "Do one thing and do it well." This is a slogan that we might consider applying to acupuncture education in the U.S.

In thinking further about Bob's blog from the other day (which you could check out after you read this one) concerning the Seattle Institute of Oriental Medicine's proposed acupuncture-only program, I am happy to see a movement in this direction. For the record, there are a few other colleges where it is possible to study acupuncture apart from Chinese herbal medicine, but, for some reason, SIOM's declaration about their new program has created quite a bit of controversy.

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Most of the first generation of Western practitioners in this country learned acupuncture first and as a stand-alone discipline. Interest in and the study of the herbal medicine came later. More to the point, certainly in China these two disciplines are separate academic pursuits! At Chinese medicine colleges and universities, you graduate from either the acupuncture or the Chinese (herbal) medical tracks, each with its own diploma.

As a current faculty member at one acupuncture school and a guest lecturer at most of the others in the US over the last two decades, I meet and speak with many students and practitioners. It is clear to me that most of them are happy to be acupuncturists and feel pretty comfortable with a needle in their hand. However, many graduate with great confusion about Chinese herbal medicine and are not sure whether they know enough about this subject to do it well and safely. Let's face it, Chinese herbal medicine (and the diagnostic and theoretical knowledge required to do this aspect of Chinese medicine well enough to be safe and successful) is another kettle of fish altogether. Chinese herbal medicine is a far larger and more complex skill set and body of knowledge than acupuncture-moxibustion. The same theories could be used to do acupuncture, but they are certainly not the only model possible for good acupuncture. Futhermore, since it is fundamentally not different from other forms of pharmacologic medicine, Chinese herbal medicine is far less forgiving than acupuncture in terms of adverse events. For the most part, when we get acupuncture "wrong" (choose the wrong points, the wrong depth, the wrong duration, the wrong style, the wrong frequency of treatment), what happens is....nothing. (Yes, yes, I am aware that injury and damage can be and has been done with acupuncture, but it is by far the exception to the rule). With Chinese internal medicine, however, if a formula is powerful enough to move someone in the direction of health when correctly prescribed and at the right dosage, it is equally capable of a deleterious effect when incorrectly prescribed or dosed.

Because the herbal medicine is as difficult as it is and requires hours and hours of memorization (a dirty word in many late-20th-century educational models), what I believe we have in this country is 20,000 acupuncturists, most of whom do Chinese herbal medicine tentatively and at lower-than-the-most-effective doses because they are not completely comfortable with how well they have learned the theory, materia medica, and formula book. Don't get me wrong, I personally know many fine herbal practitioners, and I love the herbal medicine tradition that the Chinese have developed and shared with us. However, I cannot tell you how many times I hear practitioners tell me that they "don't feel they learned the herbal medicine well enough" or they "wish they had time to go back and study the herbs again."

So, for those of us, like me for example, who are good tactile and kinesthetic learners, a program of acupuncture/tuina/qigong is a brilliant and perfect option that plays to our strengths and does not force us into learning the herbal body of knowledge that is largely visual, left-brain, and based on thorough and complete memorization of thousands of pages of inter-related facts.

Furthermore, I am not of the opinion that we all have to be Renaissance human beings who are educated about and capable of knowing and doing everything, which brings me to the Unknown Potter.

When I go an Asian art exhibit almost anywhere, there is, inevitably, beautifully lit in it's own display case, a single, fragile, perfectly lovely rice bowl made several hundred years ago. Its maker is unknown. Nothing special about it, minimally glazed, it was created for everyday use with a cheap set of chopsticks. Yet its beauty and simple perfection are undeniable.

Would we have been disappointed in the potter who made this bowl because s/he was not a scholar or because s/he was not necessarily skilled at any other profession? Is that single talent not enough for the person to be a valuable human being?

Is it that we feel we did not learn the acupuncture skills well enough that we have the need to know and do more than one thing really well? If we got really, really good at that one thing, in this case acu-moxa-hands-on therapy, would we have the need to add on the herbal medicine because it's in our scope of practice even though we have not necessarily learned it adequately to use it with total confidence?

While each of us may have our own response to these questions, congratulations to those of us who are acupuncturists-and-not-herbalists and to those who are herbalists-and-not-acupuncturists, and who are dedicated to doing just that one skill and doing it with presence, awareness, and compassion. And congratulations to the colleges across the country, including SIOM, who have created programs to teach one or the other. Maybe the above slogan could be changed to say, "Teach one thing and teach it well."