Holistic Health Assessment
It is sometimes said that in ancient China people only paid their doctors when they were in good health; if they were ill they did not pay until they got better again! This may not be historically accurate, but it illustrates the important point that the primary role of any form of health care should be to stop people getting ill in the first place; as the old adage goes, ‘an ounce of prevention is better than a pound of cure’. This is something we have perhaps lost sight of, so that we see health care in terms of curing illness rather than preventing its occurrence. Perhaps also we have a tendency to delegate responsibility for our health to someone else, rather than take responsibility for it ourselves.
Most people in the West turn to acupuncture or other forms of Chinese Medicine because they are ill. However, some people recognise how important it is to proactively preserve their health. A percentage of people also come to Chinese Medicine solely to maintain and optimise their health, without experiencing any specific symptoms.
We have a growing number of people who understand the very direct relationship between a human being’s health and their creativity, productivity, mood, and sense of general wellbeing.
A skilled practitioner of Chinese Medicine is able to assess the areas of imbalance in the Qi of any patient. Whilst for people who are ill, these imbalances are quite marked by physical or emotional symptoms, even a fit and healthy person may have them; these imbalances may be inherited, or gradually acquired through life and they represent a tendency towards, or a potential for, a particular illness.
For instance, one person may have a slight deficiency of the Qi of the respiratory system, which manifests as a mild shortness of breath or a propensity to catch colds a bit more frequently than most other people. This deficiency may perhaps be congenital, or might develop from long hours of office work hunched over a desk so that the chest is constricted. Whilst it is not a problem at present, this tendency may over the years develop into something like asthma or sinus problems.
Someone else may be relatively healthy, but their Qi may not flow quite as freely as is optimal; this is a common occurrence in modern life, the stresses and strains of which have the effect of stagnating our Qi. Again, this may not be a problem at the moment causing nothing more serious than the occasional mild headache or a little mild indigestion, but if unchecked it could develop into severe migraine headaches or irritable bowel syndrome.
TCM allows us to pick up these minor imbalances before they become serious and restore harmony; in the first example by strengthening the respiratory Qi and in the second by promoting the smoother flow of Qi in general.
Thus health enhancement in TCM begins with a diagnosis of the subtle imbalances which each individual is subject to, and proceeds to develop a health care plan to restore harmony. This plan may include regular acupuncture treatments (perhaps a short course of treatment to begin with followed by regular ‘top ups’) , some gentle Chi Kung exercises we can do at home, and some adjustments to our diet and lifestyle, if appropriate and possible. The emphasis is on the partnership between patient and clinician, the two working together to restore the balance.
Prior to advising any treatment it is necessary for the clinician to formulate a diagnosis of the patient’s symptoms, from a TCM point of view. This assessment uses the diagnostic methods described below.
The patient is asked about their medical history and the history, nature and location of their symptoms, as well as questions about their general health.
The clinician will observer various characteristics of the patient, including facial features, the quality of the complexion, skin generally, nails, hair etc, their posture and demeanour. The tongue will also be observed as it provides a wealth of information about the current internal state of the body.
The quality of the voice is listened to. A patient may sigh excessively or it may be possible to hear their digestive organs gurgling. All of this may provide valuable information to aid in making a diagnosis.
The muscle tone may be felt or acupoints may be pressed in order to determine any patterns of tenderness, in particular, the pulse is felt on both wrists. This can provide important information as to the state of the internal organs.
The culmination of these assessments is a tailored diagnosis. The diagnosis will be explained to the patient and efforts will be made between the patient and the clinician to determine the cause of any problem, whether it be lifestyle, diet or whatever. Where no symptoms exist, the clinician will explain how the patient’s overall wellbeing may be preserved or maintained.
The Treatment Plan
A treatment plan may be proposed so that each patient will be given an indication of how long it might take for the treatments to take effect. In certain cases, the patient may need to be referred to other clinicians for treatment as appropriate. In certain circumstances it is appropriate to work in close relationship with the patient’s GP, if the patient feels comfortable with this. This relationship may ensure the best possible patient-centred care.
Generally, most of our new patients come to us with a specific problem. However, we do do have patients who have a forward-looking approach to their health. These patients attend for purely preventative reasons, recognising that, say, their job or personal circumstances are such that they need to seek preventative measures to keep them in good health.