Acu. | Issue #32 | Autumn 2021
Opinion
25
The classic of difficulties Guiltiest pleasure
I reckon the guilt is worse for us than the pleasure. But, salami… the cheap kind. I know. And I’m vegetarian
Favourite song lyric
we should restructure our approach around the construct that ‘liver governs sinews’. Only a couple of authors have yet made this shift, so entrenched is the idea that PHP is a kidney problem. Now let's consider institutionallevel structures such as finances, regulations and protocols (another patch that could be added to our diagram). These impinge on practice in many ways, often unnoticed but shaping what we do. The prevailing culture of evidence based medicine (EBM) limits the activities of orthodox medics directly but its influence also percolates down to affect even independent acupuncturists, for example restricting funding by insurance companies to a small range of diagnosed conditions. Further, those diagnostic categories are defined by criteria set by the Powers That Be. There has been a move recently to replace the misleading term PF by PHP. Some authors started using it, but others have eschewed its use, reverting to the old label so that their papers are more likely to be accepted for publication and more likely to show up in literature searches. They do have a point, as we found to our cost; the old jargon is embedded in systems such as the MeSH terms used for searching databases like PubMed. In 2012 we published ‘The effectiveness of acupuncture for plantar heel pain: a systematic review’. This duly appeared in the PubMed database but it was not featured in a subsequent National Institute for Health and Care Excellence (NICE) review of the topic. Why? Because someone had failed
to include the term ‘plantar fasciitis’ in the MeSH terms, so our paper had failed to show up when the NICE reviewers did their search. Fortunately we spotted this and got it changed, but others may not. I think this illustrates how the structures of the databases (which EBM relies on) perpetuate archaic concepts which, as I showed above, can lead to bad practice. Furthermore, it seems as if the various institutional structures – funding bodies, research institutes, publishers, reviewers, databases, etc – are bound together by invisible threads, creating a meta-structure with its own tensegrity, giving it resilience to resist distortion and maintain the status quo. So there you have one person’s perspective on how the structures we inhabit influence our practice. I've started from the vantage point of PHP but I am sure the same is true for all areas of practice. I hope I have given a glimpse of how disparate factors, unrelated to discipline or training, constrain how we practise. Perhaps by paying attention to our own context, by raising our awareness of the ‘structures’ we inhabit, we can swim better with the flow rather than being carried along by the current. While I have been unable to go into depth, I hope I have piqued your curiosity. If so, please explore the resources on my website. I look forward to seeing your ideas in the discussion forum.
Perhaps by paying attention to our own context we can swim better with the flow
If we all die tomorrow then I'm planting a tree; And I hope there is a fairy who waters it for me; If we all die tomorrow then I'm p*ssing outside; Yeah there's this bush I've had my eye on for a really long time
Desert island disc
Paul Simon, Graceland The whole album, if that’s allowed
Desert island film
Amélie. For the pure joy and vibrancy
Desert island book
Man’s Search For Meaning by Viktor Frankl… life-changing
Hero/heroine
I think I’m actually my own hero
If you weren’t an acupuncturist what would you be doing? Hmm, I’d probably be a calligrapher, antique dealer or nurse
Superpower of choice
Truth detection. Honesty is important to me, even if it isn’t pretty
A one-way ticket to… Portugal
Which word/phrase do you overuse?
I love you. Although, I’d definitely rather say it too much, than not enough
Fantasy dinner party guests
Brené Brown, Roxane Gay, Malala Yousafzai, Jameela Jamil and Margaret Atwood. A fierce girls’ night in
What is your diagnosis?
You’re listening to everyone else instead of yourself
Worst nightmare
Allowing insecurities and fear of what others think to get in the way of truly experiencing life
Favourite proverb
Dimming someone else's light doesn’t make yours shine brighter
One bed or multibed? One bed, definitely
What’s your animal?
The cat life is the one for me, from kitten to lioness
What has life taught you?
It's impossible to go backwards, even when we feel like we are
Tell us a joke Acupuncture for heel pain 〉 podac.info
Brexit.
Favourite poem?
Marianne Williamson, Our Deepest Fear
Charley Roux Member: Bristol
