by Griffin Cullen-Norris
With billions of vaccines administered across the globe in order to combat the spread of COVID-19, plenty of people have needles on their minds (and in their arms). When not under pandemic conditions, getting a needle stuck in you is usually something that’s brought up every flu season. Opinions can range from ambivalence to intense fear over getting jabbed. But there are some who don’t mind getting regularly poked by a needle (or ten).
This is of course referencing acupuncture, which is but one of many practices which falls under the umbrella of TCM (Traditional Chinese Medicine, not to be confused with Trinity College Meetings, which only few will claim to have medicinal qualities). According to practitioners such as the College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario (CTCMPAO), TCM originated in China over two thousand years ago. It is infused with traditional Chinese philosophy and culture, and claims to “balance the functions of the body.” They describe the process in terms of Yin and Yang which they refer to as a philosophical concept of opposing forces which form Qi, “a type of energy that flows through the body through invisible sets of pathways called meridians” as well as the “Wu Xing” as a theory of the five Chinese elements (fire, earth, metal, water and wood) which “interprets the relationship and the constant movements and cycles between the physiology and pathology of the human body and the natural environment.”
There are also arguments in support of TCM which are rooted outside such concepts. For example, acupuncture is promoted by those outside of the traditional Chinese context as an alleged treatment for pain relief, claiming that the needles cause the body to release endorphins, lessening the patient’s discomfort. With arguments founded in tradition as well as appeals to modern medicine, TCM has become a globalized phenomenon, but not without pushback.
Scientific approaches to medical practice have produced criticisms of TCM for decades now, citing an overall lack of statistically significant success and other scientific data as evidence that TCM does not offer an effective treatment option. However, a 2009 University of Maryland study analyzed seventy systematic reviews of TCM, concluding that the majority of the “reviews of TCM are inconclusive, due specifically to the poor methodology and heterogeneity of the studies reviewed. Some systematic reviews provide preliminary evidence of Chinese medicine’s benefits to certain patient populations, underscoring the importance and appropriateness of further research” and that these “preliminary findings should be considered tentative and need to be confirmed with rigorous randomized controlled trials.” Despite the shaky evidence, TCM is still used by many who find its treatments helpful for maintaining mental and physical wellness, leading to increasing demand for its remedies. As the market for TCM grew in Canada, provincial governments felt little need to step in, allowing practitioners to offer their services freely.
But TCM had become too big for Ontario’s provincial government to ignore. In 2006, the Traditional Chinese Medicine Act was passed (the first regulation of a health profession in the province since 1991). It established the College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario through which all aspiring practitioners of TCM had to study in order to get accredited. After sixteen years of regulating TCM, the provincial government decided to loosen its grip, bringing regulation closer in line with approaches to other pseudoscientific practices such as hypnosis. Released on February 28, 2022, the Working for Workers Act was put forth to the public. As part of an effort to “deliver better protections, bigger paychecks and greater opportunities for workers and their families,” the provincial government decided recently to “Reduce the provision of traditional Chinese medicine while ensuring consumer protection in the delivery of traditional Chinese medicine and acupuncture services.” Ann Zeng, the registrar and CEO of the College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario (CTCMPAO), released a separate statement on the same day to clarify what the new measures would mean for her institution. She was informed that the provincial government “would be taking steps to wind down” the college, a process which is estimated to take approximately 18 months.
After retiring the College, the provincial government planned to hand the practice of TCM back purely to the public domain like other treatments which lack strong scientific evidence, meaning that aspiring practitioners will not need to be formally accredited in order to practice. This deregulation raised some safety concerns about TCM treatments. For example, those seeking out acupuncture would have no guarantee that the person administering the needles has been adequately trained to use sterile equipment to prevent infections or how to avoid piercing the patient too deeply, something which can lead to punctured organs or nerve damage.
Moreover, there was concern such a move will further exacerbate existing issues with unlisted products like parts of animals and plants, heavy metals, pesticides, as well as certain blood-thinning and anti-inflammatory drugs in the many herbal remedies offered by TCM. Reducing oversight on these products would make it harder for consumers to know what they are ingesting and could lead to serious health complications ranging from allergic reactions, asthma, organ damage, and/or interfering with the efficacy of certain prescription and over-the-counter medications.
Those seeking TCM were also facing financial implications as a result of the deregulation. Insurance companies are often known to not cover the expenses of medicines and treatments offered by TCM. With no guarantee that their client is receiving items or services from accredited practitioners, these companies would have even less motivation to offer coverage, leaving their clients to pay more out of pocket in order to access TCM.
Practitioners and supporters of TCM began organizing to head off these possibilities. Crowds of protestors convened around the Legislative Assembly of Ontario over the week following the announcement, and a petition of just under 40,000 signatures was drafted in opposition to the upcoming changes surrounding TCM. Andrea Horwath, Mike Schreiner, and Steven Del Duca (leaders of Ontario’s NDP, Green, and Lieberal parties respectively) took the opportunity to criticize the Ford government’s plans, adding their voices in support of the movement that was rallying to defend TCM’s regulated status. On March 7th, Premier Ford and his team felt the need to clarify their position. They reaffirmed their support for the bill and explained how they thought it would make the field of TCM more equitable, allowing for Mandarin and Cantonese who would not otherwise be able to pass the CTCMPAO’s English language exams. The Ford government ultimately folded before public pressure, set aside their plans to deregulate TCM, and are now claiming to be working towards offering Mandarin and Cantonese exams with the CTCMPAO “to break down language barriers and fix this unfair system put in place by the Liberals” in the words of Alexandra Hilkene, a spokesperson for the Ministry of Health.
This effective defense of TCM has demonstrated how accepted the practice has become in Ontario, but those within the industry feel as though there is still plenty of work to be done. Mary Wu, president of the Toronto School of Traditional Chinese Medicine, has stated that “We fought for years to get the profession recognized,” and that she and her colleagues “are going to take another 30, 60 years to do better”. As for the Ford government, their move to curry favour with voters in the face of a fast approaching election has turned into a thorn in their side. Tens of thousands of voters have had their confidence in Premier Ford shaken and it remains to be seen if his administration’s new approach can ease tensions in time for June 2. If this brief battle over the state of TCM in Ontario has proved anything, it is that TCM has become entrenched into the lives of enough Ontarians to make it an issue around which politicians must tread lightly lest they be faced with a substantial outcry from the public.