Since the Chinese medicine into Switzerland for more than 20 years, Chinese medicine clinics and engaged in Chinese medicine more and more people, the Swiss people on the recognition of Chinese medicine is also increasing, many favorable factors to promote the rapid development of Chinese medicine, to now can be said that the development of Chinese medicine in Switzerland is in full swing. However, there are still some adverse factors constraining the development of Chinese medicine, such as the uneven level of medical skills of Chinese medicine practitioners, especially the introduction of the new federal examination system implemented in 2017, so that some of the Chinese medicine practitioners who do not pass the language to lose the qualification to practise, and tightening of work visas make it difficult for domestic Chinese medicine elites to enter Switzerland, which makes the development of Swiss traditional Chinese medicine to enter a loss of talent, no one in the embarrassing situation. In view of this, to ensure the healthy and sustainable development of TCM in Switzerland, it is very necessary to strengthen TCM education.
1 Development status of Chinese medicine in Switzerland
1.1 The composition of the Swiss Chinese medicine team has about the following parts:
1.1.1 Clinicians invited from the country, which is considered to be the highest comprehensive quality of the Chinese medicine team in Switzerland, and are generally doctors of provincial and municipal Chinese medicine hospitals and teachers of Chinese medicine colleges. The strength of Swiss Chinese medicine practitioners is to see patients, and there is a lack of senior experts with attainments in theory, clinic, teaching and experiment. However, the Swiss are very sensitive to Chinese medical treatments and the results are generally very good, so these people are fully capable of handling the local medical needs of Chinese medicine. There are also many people in this group who have been out of professional practice of TCM or acupuncture for a long time but are also engaged in medical activities, e.g., those who have just graduated from formal TCM colleges and universities, those who have been serving as administrative officials, medical auxiliaries in China for a long time, or those who are teachers of other professions such as pharmacy departments and basic courses, etc.
1.1.2 People who have studied TCM in China (or in Taiwan, Hong Kong, the United States, etc.). Most of these people are locals or people with Swiss passports or permanent residence permits. Foreigners who have studied Chinese medicine have received doctoral or master's degrees from Chinese medicine colleges and universities, but they have really studied in China for perhaps only a few months. However, they are locals, with rich interpersonal and social relationships, valued by the local government, and with deeper language and cultural backgrounds than the Chinese. Therefore, these people are the ones who hold the most real power in Switzerland, especially those who have studied Chinese medicine in the West, and they are able to grasp the lifeblood of Chinese medicine.
1.1.3 People who use Chinese medicine as a front and make money under the banner of Chinese medicine. These people are most capable of damaging the image of Chinese medicine. The origin of this group of people is very complicated, and the work they are engaged in is to run schools, give lectures and teach apprentices. There are some Chinese in Switzerland who do not have the slightest knowledge of Chinese medicine, but they are proficient in German, and they also claim themselves as experts in Chinese medicine, but they hold classes and give lectures everywhere. The current situation of TCM practitioners in Switzerland can be described as a "mixed bag". If the Swiss government does not take measures to certify and clean up the TCM industry, sooner or later, like some European countries, the TCM industry will become a world of crooks.
2 Chinese medicine and common diseases in Switzerland
Acupuncture and moxibustion therapy in Chinese medicine involves a number of clinical disciplines such as internal, external, gynecological, pediatrics, etc., and treats a wider range of illnesses abroad compared to those seen in domestic acupuncture departments. The most common diseases are musculoskeletal, neuropsychiatric and immune diseases, and most of them are patients who have been treated by Western medicine and are not effective. About 90% of the patients are chronic diseases, stubborn and difficult cases or patients who want to get rid of the dependence on antibiotics, hormones and other synthetic drugs. The top 12 diseases are: shoulder and neck pain, depression, headache, migraine, lumbar and leg pain, insomnia, weight loss, tinnitus and deafness, eczema and other skin diseases, dizziness, stomach pain, pollen allergies. Other diagnosis and treatment diseases are, in order: cough and asthma, thirst, palpitation, menstrual disorders, diarrhea, constipation, sweating, addiction to tobacco and alcohol, dysmenorrhea, menopausal syndrome, fatigue, multi-joint pain, post-surgical pain, toothache, facial pain, facial paralysis, eye disease, nasal abyss, yin itch, pregnancy malignant obstruction, infertility, postpartum breast milk insufficiency, gonorrhea, malignant tumors, post-radiotherapy syndrome, pediatric anorexia, pediatric enuresis, and so on [1].
Chinese medicine is very effective for these diseases. For example, allergic rhinitis, which is regarded as a dreaded disease in China, can be treated here with acupuncture points such as Quchi, Fengchi, Yingxiang, and so on, and can receive very good results. The author often uses medicated umbilical cord compresses and cupping on the large vertebrae for treatment, which almost always relieves symptoms such as sneezing, runny nose, astigmatism and tearing in a very short period of time. Therefore, it can be said that there is much room for the development of all the remaining clinical methods of Chinese medicine, with the exception of Chinese medicine therapy. As an important supplement to Western medicine, Chinese medicine should have a promising future as it complements Western medicine and complements its strengths.
Switzerland is located in the northwestern part of China, and its geography, climate, and people's living habits are quite similar to those of the northern part of China in the book "Su Wen. The different method of prescription of "the northern region and the western region of the said:" the north, heaven and earth are closed to hide the domain, its high mountain residence, cold and bitter wind, its people music wild place and foraging, dirty cold born full of disease, its treatment is appropriate moxibustion Bing, so moxibustion Bing, also from the north." "The West, the domain of gold and jade, the place of sand and stone, the world's collection of attraction. The people of the mausoleum and windy, soil and water are strong, the people do not dress and brown recommended, the people of the Chinese food and fat, so the evil can not hurt its form, the disease is born in the interior, the treatment should be poison. Therefore, poisons also come from the west." The climate was cold, and the people mainly ate meat and dairy food, and especially liked to drink cold, so the people with cold organs and yang deficiency were common. Because of the cold weather, the food is mainly high-calorie, and stagnation in the blood vessels is also common. In terms of terrain, the latitude here is high, the winter is long, the night is long and the day is short, the intake of yang energy is insufficient, so the phenomenon of mental depression is more common. In addition, there are amazing medical problems, such as irregular menstruation, infertility and multiple endocrine disorders caused by the long-term use of birth control pills, which are very different from our national conditions. Another example is the massive use of hormone drugs, resulting in a number of sequelae, excessive surgery, pain and dysfunction and other diseases, these diseases, Chinese medicine treatment is also compared to Western medicine has a great advantage.
2 Chinese medicine in Switzerland to continue the development of favorable conditions
2.1 Swiss people on the recognition of Chinese medicine in the increasing
Acupuncture therapy since the 1990s into Switzerland, after nearly 20 years of development, has been increasingly accepted by the Swiss, more and more people in the sick when the first choice of acupuncture Chinese medicine treatment. For example, I originally in the German-speaking area of a clinic, treatment of a case from the home Christmas tree hanging lights when accidentally fell resulting in a complete loss of sense of smell patients, after repeated diagnosis of Western medicine film, never found any lesions in the brain, but half a year has not been no sense of smell, through acupuncture on the Yingxiang, Sibai 10 times, after each treatment, the patient would be able to sniff out the smell of 3-4 kinds of food, after two courses of therapy. After two courses of treatment, the patient basically regained her sense of smell. Two years later, I met the patient in a supermarket and she said that the disease had never recurred. When I first came to Switzerland, I treated a patient with bradycardia. This patient's cardiac function was only 70% when he first came to Switzerland, his heart rate was 50 beats per minute, and he missed 5-6 beats. There was no good solution for this disease, and we could only let him rest, but his cardiac function was getting lower and lower every year. After 10 sessions of acupuncture, his cardiac function rose to 89%, his heart rate was at 67 beats per minute, and the missed beats basically did not occur. This was the first time in all these years that his cardiac function had changed for the better, and it was not easy. The patient and his family cried with joy when they came to me with this result at that time. It is the miraculous efficacy of acupuncture and the trust in acupuncture therapy, I have treated so many patients who continue to recommend me new patients, daily appointments can meet the daily workload. From point to point, it is evident that more and more Swiss people are favoring acupuncture therapy as a major trend.
2.2 Reimbursable Medical Expenses for Basic Insurance, Additional Insurance
Switzerland included Chinese medicine in the basic medical insurance in the referendum on May 17, 2009, and the percentage of Swiss citizens in favor of the motion was as high as 67% at that time, which is a good indication of how much the Swiss people recognize and are enthusiastic about Chinese medicine. There are several medical associations in Switzerland, and TCM clinics can be reimbursed by insurance companies as alternative medicine therapists by joining these medical associations. Swiss medical insurance is divided into basic insurance and additional insurance. The basic insurance reimburses Western medical clinics for the costs of practicing TCM. The rider reimburses the cost of acupuncture, which can be done 10, 20 or more times, depending on the type of rider chosen by the insured. Nowadays, many people in Switzerland have additional insurance, so they can all come for acupuncture treatments. The reimbursement of medical expenses by health insurance is undoubtedly an extremely favorable factor for the expansion of TCM.
2.3 Low threshold for starting a TCM clinic
It is very easy to start a TCM clinic in Switzerland. TCM clinics operate as a business model rather than a medical model, with the main difference being that the latter does not have to pay business taxes while the former must. To set up a clinic according to this business model, the registered capital needs to be 20,000 Swiss francs, a certain size of the clinic, a Chinese medicine practitioner as well as the appropriate medical equipment and office equipment. Non-Swiss people running a clinic also need to have a B card work permit. It can be seen that the threshold for the establishment of Chinese medicine clinics in Switzerland is very low. In recent years, there have been a number of Chinese and local doctors, local hospitals jointly organized clinics. These clinics in mainland China to hire Chinese medicine practitioners, acupuncturists, each doctor can create a monthly benefit of 15,000-50,000 Swiss francs, the clinic to pay the salary of 6500-7500 Swiss francs per month, it can be seen that the clinic's revenue is very large. Because of this, the current clinic more and more open, as if springing up.
Chinese medicine in Switzerland, the welfare benefits and salary levels than the domestic level of doctors is much higher. At present, the monthly salary of each doctor in a TCM clinic in Switzerland is about 62,000 RMB, which is equivalent to the total annual salary in China. As for myself, I have worked as a Chinese medicine practitioner in a Chinese medicine clinic in Switzerland for more than two years, and I have a clearer understanding of the Chinese medicine business in Switzerland. Compared with Germany, France and other countries, Switzerland's Chinese medicine is still in its infancy, but the country's people are generally interested in Chinese medicine, so Chinese medicine in Switzerland still has good opportunities for development.
3 The main constraints affecting the development of Chinese medicine in Switzerland
3.1 The uneven level of medical skills of Chinese medicine practitioners is a constraint on the healthy development of Chinese medicine
As mentioned earlier, Swiss Chinese medicine practitioners are composed of several parts, and those who graduated from formal Chinese medicine colleges and universities in China and who have solid theoretical foundations of traditional Chinese medicine and many years of clinical experience are only part of the Chinese medicine practitioners. Therefore, Swiss acupuncturists' medical skills are uneven, due to the low level of medical skills of some Chinese medicine practitioners, medical treatment will be deviated from time to time, which will undoubtedly affect the reputation of Chinese medicine. This is also a major constraint on the healthy development of TCM in Switzerland.
3.1 .1 Some existing Chinese herbalists will be terminated from practicing medicine due to foreign language exams
Switzerland has gradually implemented a new federal exam system for Chinese herbalists since 2017. This exam requires an exam in one of Switzerland's 3 official languages, which is German, French and Italian. According to the organizers of the exam, the main purpose of this exam is to test the linguistic communication skills of Chinese medicine practitioners with their patients. This exam is a test for Chinese doctors, even in recent years, some Chinese herbalists from the United Kingdom over the English language is very good, but the official language of Switzerland can not. Now the Swiss insurance companies have made it clear that only if a Chinese doctor passes this exam will the insurance company reimburse the treatment costs.
So this exam will cause some Chinese doctors to be eliminated because of the language exam, which means that the number of Chinese doctors in Swiss clinics with high level of medical skills will be reduced accordingly. As there are very few German, Italian and French speaking doctors in China, it will be more and more difficult to hire Chinese doctors from China who can speak the official language of Switzerland as well as have a certain level of medical skills. This will lead to a decline in the overall level of medical skills on the one hand, and on the other hand, clinics that hire Chinese doctors will be closed down because insurance companies won't reimburse patients for treatments because the Chinese doctors didn't pass the language exams.
3.1.2 The reality of difficult work visas makes it difficult for Chinese physicians to enter Switzerland
Switzerland is a non-immigrant country, and after joining Schengen, many people from other Schengen countries entered Switzerland to work and live. For this reason, Switzerland has even passed a referendum calling for restrictions on foreigners entering Switzerland to work. In recent years it has become much more difficult for Chinese herbalists to get a work visa to enter Switzerland to work than in previous years. Therefore, many TCM clinics in Switzerland are unable to import Chinese doctors from China, and instead import Chinese doctors from EU countries. The difficulty in applying for a Swiss work visa will further reduce the number of high-level Chinese medicine practitioners from China entering Switzerland.
3.2 Application of Chinese medicine in Switzerland Chinese medicine is greatly restricted
Switzerland implements strict regulation of medicines, and Chinese medicine is certainly no exception. Many excellent Chinese medicine practitioners in Switzerland feel that they have no use for them, because the use of medicines is very restricted.
First of all, there are no pills, soups, creams, dans, and other colorful dosage forms of Chinese medicine here. I have been in Switzerland for more than two years, and I have used only two kinds of dosage forms: concentrated extract powder and drops. Here, the concentrated powder is imported from Jiangyin or Hong Kong, China and other places, but also from their own concentrated from the original herbs. Various medicines are mixed well according to the prescribed dosage and taken one small spoonful at a time. This dosage form, without the process of decoction, naturally produces no magic effect of Chinese medicine. The so-called drops, is the prescription of the drug is made of extremely concentrated water, after the concentration of the dosage is small enough to use "drops" to count.
Also, there is a serious lack of medicines. For humanitarian and animal protection reasons, most of the animal medicines are not available in Switzerland, not to mention rhinoceros horn, tiger bone, or pangolin, and so on, which are not imported at all. Slightly toxic medicines are also unavailable, such as white aconite and grasshopper. There are also some drugs that need to be concocted, it is even more difficult to meet the requirements. The price of medicines is very expensive, part of the medical insurance is not reimbursed, and the prescription needs to be paid by the patient, which is also one of the factors affecting the treatment of Chinese medicine. Calculated according to the effective therapeutic dose, it is 10-50 times more expensive than in China. It can be seen that although Switzerland's pharmaceutical industry is second to none in the world, the Chinese medicine industry is highly unregulated, bringing great constraints to the development of Chinese medicine.
4 Strengthening the education and training of Chinese medicine is the guarantee for the sustainable development of Chinese medicine in Switzerland[2]
If Chinese medicine is to be carried forward in foreign countries, and to play a lasting role, and to truly embody the profundity of Chinese culture, it is not enough to rely only on the importation of Chinese medicine practitioners from home to a non-immigrant country. It is necessary to educate and train Swiss natives who love Chinese medicine, and through the systematic education of Chinese medicine, make them master certain basic theories and skills of Chinese medicine, so as to facilitate clinical practice. These TCM practitioners will then continue to develop TCM and pass it on from generation to generation. Through comprehensive and systematic education and training, trainees in basic education should have mastered the basic theories of Chinese medicine and be able to use them in clinical practice by the time they graduate. Participants in continuing education and training should further master the theories of Chinese medicine through training, so that the academic level can be further improved. In Switzerland, Chinese medicine education should have both basic education and continuing education, to achieve this purpose, it is appropriate to take the state to run the education and private education combined with a variety of ways to complement each other, complement each other's strengths.
Summary and Prospect
Traditional Chinese medicine was born in China, and its theory has always been based on Chinese people as the object of research. Nowadays, facing the brand new environment of a foreign country and the expatriates with very different physique, there are undoubtedly some new situations that have not existed in the past, which can be regarded as a new field of modern Chinese medicine research. Clinical research on Chinese medicine in domestic and foreign environments to improve diagnosis and treatment can enrich and develop the theory of Chinese medicine while benefiting the local people.
In addition, the experience of pulse diagnosis and tongue examination in TCM must be re-conceptualized in Switzerland, where people's skin color and physique determine that the experience of traditional Chinese medicine cannot be applied in Europe. For example, look at the tongue, the majority of the European tongue is pink, delicate, looks like a textbook of qi deficiency, blood deficiency of the tongue, but often their cold dampness is very heavy. In terms of pulse, their blood vessels are very elastic, and most of the people are very cheerful, so it is rare to see a stringy pulse. According to the experience in China, the slippery pulse of women is mostly during menstruation, pregnancy or ovulation, and if you judge by experience, something will go wrong; the pulse of most women here is slippery and fluent. Therefore, it is important to have high-level TCM specialists in Switzerland who are familiar with local folklore. It would be best to have its own higher education institution for TCM to train its own TCM practitioners.
Switzerland is a very good country, and I would like to promote the development of Chinese medicine there as well as develop my own life path. In Switzerland, the future of the TCM career is very broad and there are many untapped virgin territories. For example, Chinese medicine has become a very popular medical technology in Switzerland, but there is no corresponding subject in all regular medical schools; the Swiss national management agency has no special organization; the scientific research institutes, which Switzerland is blessed with, have not systematically studied Chinese medicine; and the pharmaceutical industry, which is renowned in the world, has not put the development of traditional Chinese medicines in an important position. If Chinese medicine education and training can reach the above goals, and train a good number of excellent local Chinese medicine doctors and Chinese medicine researchers, just like the spread of Western medicine to China 100 years ago, Chinese medicine will have successors, and Chinese medicine will develop healthily and sustainably in Switzerland and even overseas, and Chinese medicine will be able to take deeper and deeper root in overseas.