History of TCM in BC

History of Chinese Medicine in BC 

After many years of effort, British Columbia finally brought forth legislation to license acupuncture as a profession in 1995. Because of opposition from medical physicians in BC, including the College of Physicians and Surgeons of BC (CPSBC) and notable individuals such as Dr. Lloyd Oppel, then president of Canadians for Rational Health Policy and now on the board of directors for Doctors of BC, the legislation was 23 years behind that of the United States (Nevada was the first licensed state in 1973). 

On June 21, 1999, the BC government formally recognized the full range of TCM therapies, and so began the College of Traditional Chinese Medicine and Acupuncture Practitioners of BC (CTMCA). "By regulating traditional Chinese medicine, the provincial government recognizes it as an important and valued health option in our society," then BC Premier Glen Clark said in announcing the decision. At the time, he even suggested that TCM practitioners might soon be brought into the province's Medical Services Plan.

It took concerted efforts by the Chinese medicine acupuncture community to bring BC to be the first government in North America to recognize and regulate the title of doctor of Traditional Chinese Medicine in 2003. Let’s go back in time to review the difficult journey of Chinese medicine and acupuncture legislation and practice in BC, Canada, and North America. 

A New Yorker in China

One of the most recognized stories about acupuncture in North America is the story of a medical emergency for an American in China.

In July 1971, New York Times journalist James “Scotty” Reston visited China to report on the secret meetings of diplomat Henry Kissinger with Chinese leaders. While there, Reston suffered acute appendicitis, for which he had surgery. Because the acupuncture and moxibustion treatment he received afterward to relieve the pain was so successful, he wrote an article about his experience. This story introduced Chinese acupuncture therapy to the masses in North America, and this monumental trip brought enormous attention about acupuncture to the United States.  

The Start in Canada

The history of Chinese medicine in Canada started well before Reston, of course. 

Interestingly, acupuncture was actually included in medical textbooks in both Europe and North America in the 1800s, and it was recommended to treat a variety of ills, including neuralgia, fluid retention, rheumatism, local paralysis, sciatica, lumbago, and a number of painful conditions, though the physicians of the time used it to treat symptoms without using the TCM diagnosis or framework. Because the physicians using it were only directing the needles toward points of pain, without any TCM knowledge, it was much less effective. Then, with a movement away from low-tech therapies and toward new diagnostic technology, chemical anaesthesia, advancements in surgery, and a revolution toward training future physicians as scientists, there was a push away from therapeutic procedures that could not be explained yet through scientific rationale. So, acupuncture was dropped.

While the non-Chinese community had forgotten about acupuncture, for the Chinese immigrants who came to Canada—particularly in the 19th Century as workers during the gold rush and building the Canadian Pacific Railway—Chinese medicine and acupuncture remained important. So, this long-established medical system didn’t remain forgotten forever.

In 1938, Dr. Norman Bethune, a world-renowned, Canadian-trained thoracic surgeon, was sent by communist parties in Canada and the United States to China to support the communist forces. A year later, he cut his finger while performing surgery and he died of septicemia, so Chairman Mao highlighted him as a hero and role model for Chinese people to be selfless and give everything in service of others. Because of his martyrdom in China, Canadian physicians were allowed permissions that no other Western country was allotted, including a medical exchange program.

Dr. Wilder Penfield was a world-famous neurosurgeon and professor of neurology and neurosurgery at McGill University who visited China in 1943 for a month to observe and share knowledge. In his report about his visit, Penfield wrote more about TCM than he did about his own profession, noting:

“The so-called traditional doctors are physicians of an ancient school. They are not witch doctors, nor are they charlatans. They have textbooks and records of experience. They do not operate, unless penetrating the skin with a needle may be called that. They are remarkably skilled in the treatment of fractures.” 

and

“In the Peking Union Hospital I saw acupuncture being done. It seemed to be harmless and I was assured that that this is true and that proper precautions against infection are taken. Traditional medicine consists of far more than acupuncture. It is practiced side by side with modern medicine. The modern physicians are not obviously disturbed by it, and some feel that it often succeeds though they don’t know why. I was told that 85% of appendicitis cases treated by acupuncture do not need surgery—but there is modern surgery for those that do need it!”

He and other Canadian physicians also recorded his admiration of the Chinese medical teaching programs and research, the importance of preventative medicine, and the promotion of medical services to remote countryside areas. 

Despite these positive reports, Chinese medicine and acupuncture didn’t yet make big inroads in Canada.

Chinese Medicine Re-Emerges in the West in the 1970s

After nearly two decades of closure to most of the world, China opened its doors, and in October 1970, Canada re-established diplomatic relations with the People’s Republic of China (PRC). As a result, Canadian health professionals visited China to observe TCM and China’s healthcare system. At the same time, Chinese medical delegations came to Canada to lecture on acupuncture therapy and acupuncture analgesia. 

The growing popularity of Chinese medicine and acupuncture in Canada came, in part, as a result of the public’s search for alternatives to treatments because of modern conventional medicine’s failure in addressing chronic illnesses and iatrogenic (unknown cause) health concerns. The public was starting to look for ways to take personal responsibility for their health through exercise, good nutrition, meditation, and holistic therapies. 

This loops us back to Reston’s acupuncture and moxibustion treatment to relieve his post-appendectomy surgery pain. His article was just one of many sensational accounts that touted the benefits of acupuncture and Chinese medicine, with acupuncture being called “a child of the media.” 

Acupuncture anesthesia became of particular interest to physicians in the West because of stories of patients being alert and speaking during open-heart, brain, or tumour-removal surgery, and then walking out without assistance after the completion of their surgeries. During the early 1970s, surgeries using acupuncture analgesia were being trialed in Canada, including Dr. Chin Kwo performing acupuncture on a hernia patient who was fully awake and experienced no pain during her hernia surgery.

It was because of this that in 1973, so many anesthesiologists were requesting information from the Canadian Medical Association (CMA) about studying acupuncture in China that they had to deliver form letters of response. But with so many years of training required in China, how would just six weeks of training of these Canadian professionals deliver the required knowledge and skills? Short answer: it really couldn’t. Additionally, one of the biggest barriers of bringing acupuncture anesthesia to Canada was that it was time consuming. In China, they would do a pretrial acupuncture session to determine suitability, an involved preoperative consultation with the patient that included an assessment to determine if the patient might panic during the surgery, and sometimes a week of breathing exercises prior to surgery. In addition, because there may not be a complete blockade of pain, Canadian patients were less likely to accept this than their Chinese counterparts. 

It was thought that because Canadians could opt for the ease and convenience of medication and technology, the enthusiasm for acupuncture and the lifestyle changes and commitment required for Chinese medicine would soon fade.

However, at the same time as acupuncture was receiving lots of attention in the media, the Western public was looking for ways they could address their own health, and they considered it multifaceted with social, environmental, cultural, mental, and emotional factors all coming into play. By the 1980s, self-help, personal health, nutrition, exercise, and lifestyle improvement had continued to gain in popularity.

As a result, holistic and personalized treatments and therapies also grew in popularity. 

A Battle for Legalization, Legislation, and Regulation

As early as the 1970s, medical physicians in Canada pushed for acupuncture to be kept within the scope of licensed MDs, while the Canadian Medical Association (CMA) called for regulating the needle.

During the 1970s and 80s, acupuncturists were prosecuted in Quebec and BC. Chinese medicine and acupuncture practitioners feared going to jail, so they sometimes dared not keep patient medical records in case the police came knocking. Even though they had skills and experience in Chinese medicine, many Chinese doctors were forced to change their jobs after arriving in Canada. Others practiced secretly. 

Check out this CBC interview with Mary Watterson, the first Registrar for the CTCMA , who was one of the people who was instrumental in the legalization of acupuncture in BC: Chain Across the Door. Chinese medicine practitioners had good reason to be afraid of being prosecuted. Practitioners received letters of threat of closure and legal action, were taken to court, and were fined. As a result, patients joined protests, wrote letters, and supported their acupuncturists in court.

While the College of Physicians and Surgeons of BC (CPSBC) continued to threaten to sue acupuncturists, because of the public demand for acupuncture, and at the request of the BC Health Minister, they established the Acupuncture Advisory Committee of BC in 1972, with no non-physician acupuncturists on the committee. The goal was to establish pain clinics for symptomatic treatment using medical acupuncture. One was in Vancouver General Hospital and the other in Victoria General Hospital. The CPSBC greatly limited the use of acupuncture, stating:

“Acupuncture is a medical procedure, and a useful addition to the medical armamentarium in some instances, particularly in the relief of some types of pain syndrome. The College does not recommend the use of acupuncture in the treatment of disease per se, except as noted above for the relief of some types of pain. Further, the College does not recommend acupuncture in the prevention of disease."

During the late 1980s and into the 1990s, licensed medical doctors in North America and most other Western countries opposed the use of acupuncture by non-licensed medical doctors. As they noticed the growing popularity of acupuncture, they continued to declare it a medical act so that either only a licensed physician could perform it, or that an acupuncturist could only deliver the therapy under direct supervision by an MD in a research institute. 

Biomedicine had been defined as the only system able to define health and disease but being unable to determine a biomedical explanation for acupuncture, that meant that they either dismissed it as a “primitive technique based on ancient irrational assumptions” or renamed it “medical acupuncture,” “anatomical acupuncture,” or “scientific acupuncture” to separate it from Chinese medicine. It was an antagonistic time, with the CPSBC and the BC Medical Association (BCMA) advising their members not to refer to acupuncturists without medical supervision, protesting the movement of acupuncture as a regulated health profession, and calling those delivering acupuncture treatment without a medical license  “quacks” who were too stubborn to let go of “useless” therapies like auriculotherapy and laser acupuncture.

Two main acupuncture associations, the Western Acupuncture Association of BC (WAABC) and the Acupuncture Association of BC (AABC), were pushing the government through the 1970s, 80s, and 90s to allow the public to have the freedom of choice to be treated by acupuncturists who were not trained in Western medicine. The government, however, created a Medical Advisory Committee, consisting of five members of the CPSBC and one registered nurse to advise on all matters related to acupuncture. 

The AABC launched a huge campaign of letter writing and petition signing to send to government officials and MLAs, but the Health Minister continued to state that non-physician acupuncturists would play no role, so the associations took stronger approaches, including seeking support from politician allies from opposition and the media. While they initially tried to get the government to cover acupuncture and TCM under the provincial health plan—called Medicare at the time, now Medical Services Plan (MSP)—the government resisted because of concerns about cost. 

The AABC then shifted gears and focused instead on just regulation of the profession, emphasizing its success in self-regulating the profession and saving public health care funds as the public was willing to pay out of pocket. This association was able to demonstrate its ability to organize and enact eligibility requirements, examination procedures, rules of practice, a code of ethics, clean needle technique, and more. They emphasized that the public shouldn’t have to “go underground” to access their preferred acupuncture treatments, that acupuncture would save the government on health costs, and that the demand for acupuncture treatments was massive.

The Traditional Chinese Medicine Association of BC (TCMABC), founded in 1987 by Dr. Henry Lu and colleagues, had a different approach from the AABC. While the AABC was focused on acupuncture regulation, the TCMABC wanted the whole of TCM practice, including herbal medicine, tui na, moxibustion, and other therapies to be regulated all together, rather than piecemeal. They proposed one governing body with three categories of licenses to accommodate acupuncturists, TCM herbalists, and TCM doctors. 

One of the turning points was that former Health Minister Dennis Cocke developed hypertension when he was still Health Minister in 1974. While he tried “a fair amount of prescription drugs” for a number of years, his blood pressure, though better, was still elevated. In 1985, he introduced a private members’ bill to amend the Medical Practitioner’s Act to recognize non-physician acupuncturists. He had a change of mind because of his own experience with acupuncture from a non-physician acupuncturist, and he admitted in the House that he himself had been seeking treatment that was at the time considered illegal:

    “Three years ago I availed myself of acupuncture, and my hypertension dwindled off within three months to a point where I was normal and I have been normal for that full three years. In fact, it has already reduced the chemicals that were being put in my body by 50 percent…I am standing in this House and very seriously talking about what I consider to be a first-class procedure.”

In 1989, Health Minister Peter A. Dueck put forth the Health Professions Act and released that acupuncture would be designated as a health profession under this new bill. In the fall of 1991, five acupuncture associations in BC representing a total of 236 Chinese medicine acupuncture practitioners, joined the fight for acupuncture legislation. In 1992, there was a public hearing to discuss if acupuncture should become a regulated profession, what would be the scope of practice, and should it be supervised or subject to limitations. That acupuncture should be regulated was favoured by all except the CPSBC and the Traditional Chinese Medicine Association of BC (TCMABC). The CPSBC continued to hold that acupuncture was a treatment modality and not a profession. The TCMABC stance was that acupuncture was inseparable from TCM, and they later submitted their own application for the designation of TCM. 

In the meantime, because of public pressure, in 1991, both Alberta and Quebec recognized and regulated the practice of acupuncture.

In the fall of 1991, five acupuncture associations in BC province representing a total of 236 Chinese medicine acupuncture practitioners, applying for acupuncture legislation to the Health Professional Council under the Health Professional Act.

Finally, in 1995, more than 20 years after the start of pressure from non-physician acupuncturists in BC, Health Minister Paul Ramsey announced the regulation of acupuncture as a profession. That same year, Chinese medicine acupuncture associations formed an alliance to support the future of acupuncture and TCM.

In 1996, Health Minister Andrew Petter announced the establishment of the College of Acupuncturists of BC and the approval of the Acupuncturists Regulation which defined the scope of practice for acupuncture, allowance of diagnostic techniques, dietary recommendations, and therapeutic exercise advise. With the appointment of the first board of the College, traditional acupuncture was finally approved as a self-regulated profession.

There was still a lot of work to be done, with difficult conversations about whether to include a “grandfather clause” to allow the continued practice of already trained practitioners with experience and expertise. Additionally, though acupuncture had been designated as a health profession, there was a push to expand that to TCM. As a result, in 1999, the College of Acupuncturists of BC was expanded by the government of British Columbia to include Traditional Chinese Medicine with Acupuncture as a unified college that then became known as the College of Traditional Chinese Medicine Practitioners and Acupuncturists of BC (CTCMA). That same year, the first group of 68 acupuncturists whose professional qualifications were approved by the provincial health authority were issued their licenses. Health Minister Penny Priddy, who was an acupuncture patient herself, praised the regulation and licensing of a therapy she has personally found to be effective at promoting and treating health. 

The end result was that there are four titles for the TCM profession: registered acupuncturist (R.Ac.), registered TCM herbalist (R.TCM.H.), registered TCM practitioner (R.TCM.P.), and registered doctor of TCM (Dr.TCM). 

Effective April 12, 2003, a valid registration (professional license) issued by the College became required in order to practice TCM and acupuncture in British Columbia. And on June 13, 2003, the Provincial Health Director at the University of British Columbia (UBC) grandly issued the first batch of CTCMA graduated registrants. 

In June 2024, the BC government amalgamated the colleges of TCM and acupuncture (CTCMA) with those of the naturopaths, chiropractors, and massage therapists to form the new College of Complementary Health Professionals of BC (CCHPBC).

A Change in Perspective

During the 1990s, a growing number of physicians began to recognize and recommend acupuncture and Chinese medicine treatments to their patients. 

In 1996, Vancouver General Hospital opened the Tzu Chi Institute for Complementary and Alternative Medicine. Dr. Wah Mun Tze was president of the institute, and as a UBC professor of pediatrics, he had personally seen how effectively TCM had worked alongside Western medicine in China. With a $6-million gift from the Buddhist Tzu Chi Foundation of Taiwan, the goal was to research the therapies while providing care. Unfortunately, the funding eventually ran out, but it was a positive demonstration of the openness toward non-conventional, non-Western therapies and healthcare approaches.

In 2018, six cities BC— Burnaby, Richmond, Vancouver, Surrey, North Vancouver, and Victoria—formally proclaimed the third Sunday in April of each year as their city's "TCM Acupuncture Day."

Training TCM in BC

The first TCM school in BC was a three-part correspondence program through the school North American College of Acupuncture (NACA) established in 1972 by Kok-Yuen Leung. It took approximately two years to complete the program, but the program itself only lasted until 1974, as Leung was charged with illegally operating a medical school and the program closed. 

Also in 1972, naturopath Hermies Tong established the College of Acupuncture and Herbal Medicine in Vancouver, but after delivering only two lectures, he closed his school under pressure from the College of Physicians and Surgeons of BC (CPSBC). Both he and Leung left BC for the United States.

In Vancouver, in 1973, Dr. Henry Lu, assisted by his wife Janet, founded the Academy of Oriental Heritage (AOH). Born in Taiwan, he moved to Canada and received his PhD in education at the University of Alberta and then taught there. Using his background in language, education, and philosophy, he started translating original Chinese texts, including the Huang Di Nei Jing (Yellow Emperor’s Classic of Internal Medicine) and he launched a correspondence course in acupuncture, selling his translated books to his students, many of whom were Canadian and American physicians. Not long after that, he added a correspondence course in tui na. While he was criticized for trying to teach the manual therapies of acupuncture and tui na by mail courses, it was the only way he was able to avoid being stopped by the CPSBC. Dr. Lu continued to publish many more texts, journals, and charts, including ones on acupuncture, herbology, and TCM food cures. 

In 1985, Dr. Wee-chong Tan, a PhD biochemist and Anglican minister, opened the Canadian College for Chinese Studies in Victoria, which included an acupuncture and TCM program that was named Academy of Science of Traditional Chinese Medicine. Though Dr. Tan was not a TCM doctor, nor had he ever taught TCM, he opened the first three-year full-time English program in TCM and acupuncture which required 1980 hours of study, including 250 hours of clinical experience. He managed to avoid conflict with the CPSBC by having BC-licensed medical doctors as faculty and supervising clinical practice. In May 1988, the first nine students graduated from the program which was praised by the president of the Acupuncture Association of BC (AABC) Mary Watterson and by the Acupuncture Society of Alberta (ASA), both of whom recognized the school’s program, though the CPSBC stated, “these individuals have no legal status in the province.” In 1991, East West Medical Society, a non-profit organization took over managing the school and renamed it to the Canadian College of Acupuncture and Oriental Medicine (CCAOM), and the school became accredited as a private post-secondary educational institute in BC. After 1997, the college made the program a four-year program of 2592 hours of instruction.

In 1986, Dr. Lu started the Canadian College of Acupuncture and Herbology in Victoria, BC, changing the name in 1988 to International College of Traditional Chinese Medicine, and opening a Vancouver campus in 1989. This school started with a three-year full-time program with only six students. The curriculum was similar to that of the CCAOM except that it also included the study of classic Chinese medical literature. The school grew and changed its program to a four-year full-time program of 2100 hours.  In 2015, the school was donated to the Buddhist Compassion Relief Tzu Chi Foundation Canada, an international charity organization, and in 2018, the school changed its name to Tzu Chi International College of Traditional Chinese Medicine. 

More private schools began opening through the 1990s, and some of the public post-secondary schools began to offer TCM programs and courses in later years, including Vancouver Community College (VCC), Langara College, and Kwantlen Polytechnic University (KPU). 

In 2024, KPU became the first to offer a degree program in Canada, launching its Bachelor of Traditional Chinese Medicine degree.

The World Health Organization (WHO)

In 1958, the WHO redefined health as a state of physical, social, and emotional wellbeing, not just the conventional medical definition of the absence of disease, and they took an emphasis on preventative wellness. They followed this up with a traditional medicine program in 1977, and though it was aimed at developing countries, it also had some impact on developed nations like Canada. 

The WHO co-sponsored the International Congress of Traditional Medicine in Beijing in 1991, and October 22nd was declared “World Traditional Medicine Day.” Even further, the WHO promoted acupuncture as a low-cost, low-side effect, highly effective therapy to address over 200 commonly encountered clinical disorders, and they have long sponsored acupuncture training courses around the world.

In 2022, the WHO announced the inclusion of TCM terminology into their list of standard terminologies. 

What’s in a Name?

During the 1970s the term “holistic medicine” was the preferred name for therapies like acupuncture, Chinese medicine, naturopathic medicine, chiropractic, and massage therapy. In the 1980s, that changed to “alternative medicine,” and in the 1990s, it became “complementary medicine.” 

Now, “alternative” and “complementary” are considered biased and derogatory terms for these therapies. Alternative means “instead of,” and most people are not having to pick either conventional allopathic medicine or non-conventional or traditional medicine. Complementary sounds like a side dish or condiment, not a stand-alone therapy or treatment. Neither is accurate. The preferred term is “integrative” because this creates a better understanding of the value and how the public accesses these therapies alongside allopathic therapies.