I was recently asked “What exactly is a Dr. TCM?” and to my surprise we engaged in a fairly lengthy conversation so I thought perhaps I should take the time to explain the variety of practitioners and their scope of practice here in BC (each province is different). The following are the ONLY legislated and regulated TCM designations and are governed by a regulatory body called the CTCMA (www.ctcma.bc.ca). What this means is that the individual has passed both a written and “practical” examination put on by the regulatory body (could be BC or Pan-Canadian, this year was the first for national exams). I will admit the subject is a bit dry but it is really important for you to be able to make an informed choice for your healthcare (ugh, heavy!) If you read no further than this paragraph no problem, BUT please know that currently, NO DESIGNATION is qualified or authorized within their scope of practice to perform an internal pelvic exam of any kind. Perhaps they were an MD in another country and have the experience but if their only recognized designations come under the TCM umbrella then they are NOT authorized to perform them here in Canada. And if that is the only thing people get from this I am a happy camper.

So here goes:

1) R. Ac.: Registered Acupuncturist and is authorized to practice acupuncture

Their scope of practice allows them to puncture the skin with needles and perform a variety of other TCM techniques like cupping, gua sha, tui na, electrical stimulation etc.

2) R.TCM.H: TCM Herbalist

They are authorized to prescribe, compound or dispense Chinese herbal medicine.

3) R. TCM.P

Registered Traditional Chinese Medicine Practitioner. This is an interesting designation because it isn’t really a designation of it’s own. Basically this is someone who has passed both the acupuncturist and herbalist exams. So instead of being an R.Ac, and an R.TCM.H. they are an R.TCM.P. One of the restrictions on an R.TCM.P. is that if they have not seen significant change in a patient’s condition within three months they are required to refer the patient to either a Dr. TCM or an MD.

4) Dr. TCM: Doctor of Traditional Chinese Medicine

This is the highest level of licensing. A Dr.TCM has passed the Acupuncturist, Herbalist and Doctor licensing exams. In the words of the regulatory body, the CTCMA, a Dr. TCM is “a registrant authorized to practice acupuncture, and prescribe, compound or dispense Chinese herbal medicine. This registrant has met training/examination requirements at a higher level than registrants with the other titles.” On a little side note, it is common for people to complete a Doctor of TCM program in school but not complete/pass the subsequent exams to entitle them to the Dr. TCM title. Often these individuals will represent themselves as a DTCM or Doctor of Traditional Chinese Medicine, both of which are misleading. In addition, both of the above titles are protected designations by the CTCMA meaning that legally, the individual cannot use them unless they are licensed as such.

Whew. So what’s the difference between an R.TCM.P. and a Dr. TCM you ask? Well, at the moment, they very well could have the same education, however, one has written more exams than the other, displaying a deeper understanding of principles and application. I know a lot of practitioners who decided not to write their Dr. exam because they didn’t believe that it gave them an advantage and just cost more money. Currently the scope of practice of the Dr. title is under review so that could change. Personally I’m hoping that one day the Dr. title will be able to do things like order lab tests, perform internal exams, become a specialist and the list goes on, all of which will help differentiate the various titles.

So….. how about the Nutshell?

Acupuncturists are authorized to practice acupuncture but not herbs.

Herbalists are authorized to practice herbs but not acupuncture.

TCM practitioners are authorized to practice herbs and acupuncture but have to defer to a TCM or Western doctor if things are too complicated for them.

TCM Doctors are authorized to practice herbs and acupuncture, have displayed the highest level of licensing competency, and may have a much broader scope in the future.

If you have any questions or want help finding a qualified practitioner in your area please feel free to drop me a line.

All the best,