SELF ORIENTALIZATION IN THE EAST ASIAN MEDICAL COMMUNITY IN THE UNITED STATES by Stephen Jackowicz

Summary

Dr. Steve Jacquez discusses the history and sociocultural dynamics of East Asian medicine in the United States, from its early presence in ethnic enclaves to its mainstream integration in the 1990s. He explores how orientalism shaped perceptions of East Asian medical practices as mystical and ancient, leading to self-orientalization among practitioners. This process, driven by market forces and patient expectations, compromises the integrity of East Asian medicine and practitioners' identities. Jacquez emphasizes the tension between maintaining traditional medical efficacy and adapting to Western stereotypes, which affects the broader community and limits potential development in the field.

Takeaways

• 😀 East Asian medicine refers to the pre-modern medical systems of China, Japan, Korea, and Vietnam, influenced by Confucianism and shared medical practices.
• 😀 The four major techniques of East Asian medicine are acupuncture, moxibustion, herbs and diet, and physical manipulation (including massage and breathing techniques).
• 😀 The history of East Asian medicine in the U.S. can be divided into four periods: closed community period, counter-cultural period, professional life century period, and modern integration.
• 😀 The 'closed community period' (mid-1800s) was marked by East Asian medicine being practiced in ethnic enclaves, with limited mainstream recognition.
• 😀 The 'counter-cultural period' (1960s-70s) saw East Asian medicine gain attention, especially during the counter-culture movement, though it remained outside mainstream medicine.
• 😀 The 'professional life century period' (1970s-80s) marked the establishment of the first acupuncture school and licensure programs, allowing for wider recognition and practice.
• 😀 By the late 1990s and early 2000s, acupuncture became more mainstream, with insurance companies and even the Veterans Administration covering acupuncture treatments.
• 😀 Orientalism, as described by Edward Said, involves the Western exploitation and misrepresentation of Eastern cultures and practices, portraying them as mystical and inferior.
• 😀 Self-orientalization refers to how practitioners, especially immigrant and Asian American doctors, adapt their identities and practices to meet Western expectations of Eastern medicine as a mystical tradition.
• 😀 Foreign-trained East Asian medicine practitioners in the U.S. face challenges such as limited licensure, employment in ethnic enclaves, and difficulty accessing medical privileges like lab tests, which leads to a forced adaptation of their practices.
• 😀 The self-orientalization of East Asian medicine practitioners can undermine the legitimacy of the practice, limit its development, and promote a focus on profit over integrity, ultimately damaging the field's ethical foundation.

Q & A

What is East Asian medicine and how is it distinct from Traditional Chinese Medicine (TCM)?

East Asian medicine refers to the pre-modern medical systems developed in countries influenced by China's Confucian system, including China, Japan, Korea, and Vietnam. It encompasses practices like acupuncture, moxibustion, herbal medicine, physical manipulation, and massage. Unlike Traditional Chinese Medicine (TCM), which blends Eastern and Western medicine in modern China, East Asian medicine is a historical term that refers to the traditional medical practices of these countries before Western influence.

What are the four major approaches used in East Asian medicine?

The four major approaches used in East Asian medicine are acupuncture, moxibustion, herbal medicine, and physical manipulation (such as bone setting and massage), as well as breathing techniques.

What are the four key phases of East Asian medicine's transmission to the United States?

The four key phases are: 1) The Closed Community Period (mid-1800s to early 1900s), where East Asian medicine was practiced within ethnic enclaves; 2) The Counter-Cultural Period (1960s-1970s), where interest grew due to counterculture movements; 3) The Professional Life Century Period (1970s-1980s), when licensing began and East Asian medicine became more formalized; and 4) The Mainstream Acceptance Period (late 1990s onwards), when acupuncture and other practices became more widely covered by insurance and integrated into mainstream healthcare.

How does Edward Said's concept of 'Orientalism' apply to the practice of East Asian medicine in the United States?

Edward Said's concept of 'Orientalism' critiques the Western view of Eastern cultures as exotic, mystical, and backward. In the context of East Asian medicine in the U.S., Orientalism has led to these medical practices being perceived as not only therapeutic but as 'wisdom traditions,' often associated with mystical or spiritual elements. This perception distorts the true nature of the medicine, focusing on its cultural mystique rather than its proven medical efficacy.

What is 'self-orientalization' in the context of East Asian medicine in the U.S.?

'Self-orientalization' refers to the phenomenon where East Asian medical practitioners, especially those trained in the U.S., adapt their practices and identities to conform to Western expectations. They may present East Asian medicine as a mystical or ancient wisdom tradition to appeal to a market that desires this exoticized view, even if it means compromising their professional integrity and the authenticity of the practice.

How has licensing of East Asian medicine practitioners evolved in the U.S.?

Licensing for East Asian medicine practitioners in the U.S. began in the 1970s. The New England School of Acupuncture, established in 1972, was one of the first schools to offer formal education in East Asian medicine. By 1976, licensure for acupuncture started, and by the early 1980s, it became widespread across most states. Today, acupuncture is covered by many insurance plans, although herbal medicine and other East Asian practices are not always covered.

What challenges do foreign-trained East Asian medicine practitioners face in the U.S.?

Foreign-trained practitioners of East Asian medicine face several challenges, including limited licensure options, as only three states (New York, Massachusetts, and California) allow them to directly practice. In most other states, they must undergo additional training at U.S. institutions. Additionally, they often work within ethnic enclaves, as their cultural and medical approaches may not fully align with mainstream U.S. expectations.

What are the primary employment options for Asian American practitioners of East Asian medicine?

Asian American practitioners of East Asian medicine typically have two primary employment options: working in clinics that cater to patients from their ethnic background or working in private practices with mainstream patients. These practitioners may not have the same cultural connection to ethnic enclaves as foreign-trained practitioners, and their education is often influenced by the orientalist perspectives in American society.

What impact does self-orientalization have on the integrity of East Asian medicine in the U.S.?

Self-orientalization can erode the integrity of both the practitioners and the practice itself. As practitioners adapt their behaviors and presentations to meet cultural stereotypes, they may compromise their authenticity, adopting an identity that does not align with their true professional self. This can undermine the medical efficacy of East Asian medicine, presenting it as more of a mystical or commercialized practice rather than a legitimate medical discipline.

How does the market-driven nature of East Asian medicine in the U.S. affect its ethical foundation?

The market-driven nature of East Asian medicine in the U.S. often pressures practitioners to conform to patient expectations, sometimes prioritizing profit over ethical considerations. This may lead practitioners to present their services as more mystical or culturally exotic, which compromises their integrity and professional ethics. This shift can result in a loss of self-satisfaction for the practitioners, as they may feel that they are not practicing medicine as they truly believe it should be.