SNV Story No. 6: Traditional Chinese Medicine (TCM)

In 2015, the Nobel Prize in Medicine was awarded for the first time to a Chinese TCM expert for the discovery of the antimalarial agent artemisinin (qinghaosu). As far back as 20 years before this milestone, Professor Yiming Li, as Director of TCM Ming Dao AG, began collaborating with ZURZACH Care and integrated a TCM clinic into the Bad Zurzach rehabilitation clinic – a first for Switzerland. The collaboration has been highly successful for both sides, relying as it does on the interaction of both conventional Western-influenced and Chinese medicine. Today, patients can immerse themselves in the world of TCM at over 12 different locations.

TCM Ming Dao AG is a member of the INB/NK 1249 Complementary Medicine, and the associated ISO/TC 249 Traditional Chinese Medicine. The ISO Committee for Traditional Chinese Medicine is one of the more active committees with 23 Participating Members and 24 Observing Members worldwide, as well as numerous publications. Did you know, for example, that the quality of ginseng seeds, the single use of acupuncture needles or even the colour chart for computerised tongue analysis are all standardized? Currently, 67 ISO standards have been published and 29 are in development.

The TCM Ming Dao team

SNV: In which countries has TCM been developing and spreading the most in recent years?

Professor Yiming Li
Originally from China, TCM spread through East Asia to the USA and Australia. In the USA and Australia, the profession of “Doctor of TCM” in particular has become highly regarded, thanks to the good training opportunities in acupuncture and Oriental medicine.

In Europe, TCM is most common in the UK, but also in the Netherlands, where TCM is fully integrated into the health insurance system. TCM has become more and more important in Hungary in recent years, where TCM is taught to the same level as conventional medicine.

Switzerland has long been known beyond the country’s borders for its high-quality TCM offering, and acupuncture has become one of the most popular methods within alternative medicine. TCM is well integrated in the health system in Switzerland. When it comes to reinforcing the position of TCM in Switzerland over the longer term and further establishing its place in the health system, it is essential to focus on providing training opportunities at university level.

SNV: To what extent are you and your institute still exchanging experiences with China, TCM’s country of origin?

Rainer Blaser, Professor Yiming Li
Nanjing University of Chinese Medicine (NJUCM) is the “cradle” of TCM higher education in China, and has been the “WHO Collaborating Centre for Traditional, Complementary and Integrative Medicine (CHN-36)” since 1983. TCM Ming Dao continues to maintain close contact with NJUCM to enhance the relationship between the two countries through clinical service, education, research and high-quality health promotion. In 2016, TCM Ming Dao received an award from the National Administration of Traditional Chinese Medicine for this collaboration.

SNV: To what extent has the inclusion of TCM in the official International Statistical Classification of Diseases and Related Health Problems further increased its appeal since 2019?

Professor Yiming Li
The inclusion of TCM diagnoses in the 11th version of WHO’s International Statistical Classification of Diseases and Related Health Problems (ICD 11) was certainly a clear signal that TCM is a medical discipline in its own right, and with its holistic treatment methodology, has helped to gain more acceptance and appeal. But it will take some time before implementation in practice with the standardized diagnoses (ICD) becomes widespread.

Professor André Aeschlimann
WHO is an internationally recognised institution founded in 1948 with the aim of achieving the highest possible level of health for all. With its 194 Member States, it plays a leading role in global health issues and in shaping the research agenda for health, setting standards and formulating evidence-based policy options.
WHO provides technical support to its Member States, assessing and monitoring factors such as health developments. One of the institution’s key goals is to strengthen of health systems and the utilisation of research results, data and findings.
TCM is well established in the health systems of many countries. It plays an important role in the prevention of disease in particular, by taking a holistic approach to the body and reinforcing the individual’s own strengths. TCM can’t be compared easily with the structural thinking of Western medicine: the insights gained by TCM doctors are not based on genetic, immunological or pathophysiological knowledge and skills, but on experience passed down over thousands of years, in an approach that can be regarded as functional thinking.
The inclusion of TCM in the ICD now enables a dialogue “at eye level” between both approaches, and there will be new momentum for getting the best out of both worlds for the benefit of patients in areas such as teaching and research.

SNV: Why does it make sense to try to fit a comprehensive medical system that has been handed down over thousands of years and many generations into modern standards?

Professor Yiming Li
Bringing together old and new TCM knowledge in the form of standards enables TCM to be established and disseminated as an evidence-based approach to medicine, and makes a significant contribution to promoting quality improvement and assurance in clinics and practices, as well as strengthening the profile of TCM in science and society.

Professor André Aeschlimann
In medicine, modern standards aim to document the efficacy and appropriateness of a method or a development in a structured manner, with a view to improving quality on a continuous basis. Working with modern standards does not mean having to part with a “comprehensive system handed down over thousands of years and many generations”. Modern standards will, however, make it possible to bring the unique philosophy of TCM closer to Western medicine, to promote understanding and underline the value of TCM. Modern standards will also serve as the basis of a common language between both medical approaches, and will facilitate access to evidence-based research.

SNV: In which areas do you see the biggest need for developing clear standards?

Professor Yiming Li
When it comes to further developing therapeutic TCM methods, clear standards are needed in the areas of clinical practice, research, teaching and quality. In addition to compliance with ISO standards, the PDCA (plan-do-check-act) cycle is an important tool for achieving continuous improvement in all areas. For TCM Ming Dao, our focus is on quality, with the patient clearly at the centre.

Ralf Bauder
TCM Ming Dao runs several practices at various locations in Switzerland, and is certified according to ISO 9001:2015. We ensure compliance with quality standards by setting clear priorities and focussing on a high level of patient satisfaction. A good customer relationship is extremely important to us. Some of the key elements that enable us to achieve these goals are:
- Standardized procedures and processes at all TCM Ming Dao locations
- Guaranteed quality of treatment, and optimised treatment processes
- Multiplication of the broad expertise of TCM doctors and mutual representation
- Continuous improvement: we are good, and aim to excel
- Intercultural exchange

Dr Cyril Aeschlimann
Standards are not laws, but general rules or recommendations. As such, their application is not mandatory, and they are not legally binding. Standards may have legal implications, however, if they are referred to in laws or regulations, for example. The possibility of referring to standards offers a range advantages for legislators. If a standard is not suitable as a template for a legislative enactment due to its scope of regulation or in the required form of presentation, for example, or if the subject matter of regulation can be adapted and developed further with a corresponding standard. As a rule, standards are more accessible in terms of language and content than legal regulations, which also leads to better acceptance in practice. There is great potential here.

Standards can and should be adhered to when it comes to optimising patient care, with a view to ensuring high levels of quality and hygiene. Back in January 2014, TCM Ming Dao became the first institution in Switzerland to be awarded ISO 9001:2008 certification for its quality management system at all its centres. Standards also help to identify increasing demands in terms of quality. Quality requirements are ordered according to their priority, depending on the area of patient treatment, including the related ancillary activities.

Professor André Aeschlimann
The aim of «clear standards» in medicine is generally to improve the quality of a treatment, to identify early warning signs so they can be avoided when undesirable events occur. The well-being of patients has priority at all times.

A high-quality service is also extremely important in TCM. In terms of the patient, this concerns the standardization of treatment (from the provision of information about the treatment itself to the quality of the outcome), and TCM practitioners participate in continuous training and development with this in mind. The high-quality service also enables society to benefit from health protection, especially in the development and marketing of medicines or devices.

Ursula Haimel
When it comes to everyday administrative processes, efficiency and above all the ability to respond quickly and flexibly to patients are the most important points for competing successfully in the market. Clear organisation of processes in the areas of patient administration, patient billing and secretarial services, embedded in a reliable quality management system, provides structure and security for staff, as well as space for continuous improvement.

SNV: How does your involvement with the standardization committee help you in your daily work?

Professor Yiming Li
TCM Ming Dao is the first TCM institute in Switzerland to be a member of the standardization committee of the SNV. Membership of the SNV makes it possible to exert active influence and ensure participation, and the SNV offers a communication platform for an international exchange of views on a professional basis. TCM Ming Dao will continue to participate actively in the realisation of “ISO/TC 249 Traditional Chinese Medicine”.

Dr Cyril Aeschlimann
Above all, the standards go beyond their significance as general rules or recommendations in day-to-day work: access to standardization committees, and the possibility of influencing standards in their development or revision, make it possible to promise quality in patient treatment for the long term, going beyond the expectations of patients and at the same time forming the basis of the strong reputation of and trust placed in Traditional Chinese Medicine in general, and in Switzerland in particular. To ensure that this remains the case in the future, the importance of standards in the practical world of work and in the environment of laws and regulations will certainly continue to increase.

SNV: You are working closely with the Nanjing University of Chinese Medicine in China to jointly establish a China-Switzerland TCM Centre in Switzerland. What projects have already been implemented here and what is currently in development?

Rainer Blaser, Professor André Aeschlimann, Professor Yiming Li
The China-Swiss TCM Centre aims to define TCM standards and become integrated in professional associations, exert influence on the further dissemination of original TCM, and support the relationship between the two countries through clinical service, education, research and health promotion.

We will continue to focus on the realisation of the China-Swiss TCM Centre, expanding our offering as a TCM training centre and further intensifying our collaboration with the NJUCM.

Many thanks to the entire TCM Ming Dao team for a fascinating conversation!

1. Even if you have already been vaccinated, recovered or tested, continue to wear a protective mask. A large proportion of COVID viruses enter the body through the respiratory tract. From a TCM perspective, continuing to wear a mask will enable you to protect and strengthen your immune system and your lungs, and thus the «qi» (life energy).
2. With the prolonged cold weather having further weakened the body this year, avoid cold drinks and foods and focus on regular warm meals.
3. Following physical exertion and sweating, it is important to dry the body completely with a towel after your shower, until a slight redness appears. This also helps to stimulate and strengthen the immune system.

TCM Ming Dao
ZURZACH Care
ISO/TC 249 Traditional Chinese medicine
WHO worldwide