Obstacles to Integrative Medicine : The Case of Traditional Chinese Medicine in Taiwan

The model of regulations on Traditional Chinese Medicine (TCM) in Taiwan is often categorized as “equalization” or “non-discriminatory,” though in reality the TCM practice is unequally regulated or even marginalized. The thesis of this Article is that medical licensing law in Taiwan played a major role in marginalizing TCM in the medical system and thus delayed the acceptance of TCM by orthodox medicine. First, this Article will describe the “separate-but-equal” doctrine in determining the scope-of-practice issue of TCM regulations. The doctrine exclusively defines the practice boundaries of TCM doctors, thereby obstructing the modernization of TCM practices. Some examples indicate this issue is equally important in the Western world. Second, this article will examine why medical licensing law can be an obstacle in the integration of TCM and modern scientific medicine (MSM). This Article adopts Thomas Kuhn's paradigm theory to explain the active function of licensing law in purifying and reinforcing the collective beliefs of a scientific community. Additionally, it explains why medical licensing law in Taiwan should be amended to allow TCM doctors to integrate MSM and other complementary and alternative medicine (CAM) traditions into their practices. Finally, the Article proposes the term “competitive professionalism” as an alternative principle to replace the segregation policy on the scope-of-practice issue. This principle views healthcare professions as competing entities that share the same pool of medical knowledge, and which should serve for the benefit of all patients. The intersections between intellectual property rights and antitrust law can be metaphors for the functions of title protection and scope-of-practice settings. The practice boundaries of healthcare professions should be set up in reference to the training and education of such professions. Under this model, medical licensing law will suit the social demands put on integrative medicine and medical pluralism