Integration of Biomedical and TCM Knowledge
Consultation Drawing upon your own clinical experiences, you will select a case to prepare and present as if you are calling another healthcare professional for a consultation or referral. A good case will contain a diagnostic dilemma where the acupuncturist thinks additional biomedical testing and diagnosis will add to the patient’s outcome.
• Innovative discussion of diagnosis
• Clinician’s current assessment / working hypothesis is articulated
• Synthesized TCM knowledge and Biomed knowledge to create a deeper understanding of the disease process.
• Discussion between clinicians’ probes for options, alternatives, and possible ways to proceed Presentation of case logically leads to a question or diagnostic dilemma
• HPI, pertinent negatives, pertinent psychosocial or family history presented
• Objective, physical exam, lab or imaging findings
• TCM findings are included in a manner understandable to a biomedicine clinician DAOM professionally introduced themselves and the mutual patient
• Case presented clearly, articulately, and efficiently
• Consulting professional engaged in dialog and conversation
• Both parties clear about the situation and how the patient will follow up
• Integrative diagnosis work-up plan (A,B,C,) Building on the information gained in the consultation as well as peer-feedback of Difficult Case Presentation, students will present a work-up plan for further diagnostic testing and imaging.
(You will need to know how to understand and interpret different Lab results as well as MRI, CT, X-ray, reports.)
A. Decision tree
Please include a decision tree which shows what you will do at each step depending on which part of your decision tree path you follow.
The work-up plan should include what happens next based on either result. For example, an imaging study is normal and the patient is still in pain (now what? More tests?) vs. the imaging study is definitive (how does the treatment/team change?). Below is an example of what a decision tree looks like in medical decision making.
Using this example, create your own decision tree of your case.
1. Ensure your decision tree contains the following elements:
i. Construct your decision tree in Microsoft Word
ii. Start with the chief complaint
iii. Think about the questions you want to ask that will help you diagnose your patient, write those questions in the rectangle.
iv. The answer will either be yes or no. Draw a line from the question rectangle and label one line “yes” and the other “no”. At the end of the line will be a rectangle with the next question and repeat the process.
v. While going through this process, decide what laboratory tests, imaging tests, referrals you need to make in order to rule out different differential diagnoses. Ensure any laboratory test or imaging test you mention in your decision tree is accurate and your rationale behind your choice is clear.
vi. Include all pertinent TCM findings in your decision tree.
vii. You will repeat this process until you reach either a diagnosis or a treatment plan.
B. Work Up Plan
Work-up plan should also include a summary of your difficult case, and the latest diagnostic and treatment plans in Conventional medicine and in Chinese medicine for this case. (At least three citations for Western medicine treatments and two citations for TCM treatments are required). This is about two to three pages.
Integration of Biomedical and TCM is required: synthesized TCM knowledge and Biomed knowledge to create a deeper understanding of the disease process. TCM findings are included in a manner understandable to a biomedicine clinician C. Prepare a written plan to share with your patient –one page.
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