| Background: In recent years,Traditional Chinese Medicine(TCM)service trade is in a period of rapid development,in which TCM medical service is the core content of TCM service trade,and commercial presence is the most important way to provide international service trade.However,the export scale of practitioners of TCM medical service trade is not large on the whole.One of the important reasons is that it is difficult for China to export medical talents in large scale due to the barriers of qualification access,which seriously limits the development scale of medical service trade in China.From an international perspective,the United States plays a role as a benchmark and pilot in the whole western medicine field.The U.S.market is the key to open the international market of TCM and realize its internationalization.At the same time,the U.S.TCM service trade market has a huge development potential.It has a long history of TCM acupuncture legislation,mature management,and a strong representation of the licensing access mechanism.Objective: To reviews the relevant requirements in acupuncture legislation of each state on the employment qualification,comprehensively summarizes and compares the key points and management characteristics of the TCM and acupuncture qualification requirements in each state;Based on the trade barriers formed by the practice qualification in each state of the United States on the TCM medical services trade of China,this paper discusses the development strategy of TCM medical services trade in the United States market,and provides theoretical and practical basis for TCM management departments,TCM medical service providers and individuals to formulate the development strategy of the TCM medical services trade.Methods: By logging into the official website of acupuncture administration departments in 47 states and 1 district of the United States,legal documents with names of law,act,station,regulation,rule,code or other file names are downloaded,content in acupuncture legislation of each state is sorted out and analyzed,scope of practice,application conditions and approval requirements of acupuncture license,including citizenship of license applicants,education background,qualification examination,English proficiency requirements,Chinese herbal medicine use,license mutual recognition provisions,Western doctors' employment requirements,acupuncturist title management and other contents were mainly compared.Based on the description and analysis of the qualification data obtained from NCCAOM website,the management characteristics and current situation of the qualification access of acupuncture practitioners in the United States are summarized.Combined with the expert consultation method and SWOT analysis,based on the results of literature research,this paper analyzes the barriers of the mode of commercial existence and natural person flow of TCM medical service trade in the United States,and puts forward corresponding strategies and suggestions.Results: In terms of the identity of applicants for acupuncturist license,most states accept nonU.S.citizens,only Mississippi requires applicants to be only U.S.citizens or permanent residents;All states and districts that have made laws on acupuncture or TCM have requirements for acupuncture professional education,and the main certification standard is ACAOM,but there are slight differences in curriculum,education modes and class hours requirements among states;All States have qualification examination requirements,and the main stream of States is to use NCCAOM examination,but some states also have their own examinations;18 states and the District of Columbia(37.25%)have requirements for English proficiency of non-U.S.citizen applicants;18 states(35.29%)allow acupuncturists to use Chinese herbal medicine within their practice scope,and 11 states(21.57%)require acupuncturists to pass the Chinese herbal medicine examination before they use Chinese herb;most states only support the mutual recognition of acupuncturist license in the United States,and only a few states,such as Kansas,Arkansas,Utah and Minnesota,indicate in the bill that the acupuncturist license in other countries or regions can be evaluated by the Committee;In terms of title management,unless the acupuncturist has a doctor's degree,the title of "doctor" shall not be used,and some states shall not allow the acupuncturist to use words such as "medical treatment" to distinguish it from the mainstream Western medicine.Conclusion: The main characteristics of the TCM and acupuncture qualification admission mechanism in the United States are: the development of TCM in the US states is very uneven,and the overall trend of the TCM and acupuncture qualification admission mechanism is generally the same,but specific management requirements in each state are diversified;the main stream of the professional qualification assessment is NCCAOM examination or certification;the content of Western Medicine still accounts for a large proportion in the teaching and examination of TCM and acupuncture in the United States,which still has important reference for the development of TCM;The prospect of apprenticeship is not optimistic,and it is an important task for the development of TCM education to explore a new model.With the localization of the acupuncture industry in the United States,the acupuncturists and TCM medical services trade will face fierce competition from local acupuncturists.The increasing threshold of TCM practitioners in the United States has formed a high trade barrier for the TCM medical services trade of China.In view of the above problems,from the perspective of four strategic combinations of SO,WO,ST and WT,the corresponding development strategies are put forward from three aspects: policy-making of relevant departments of TCM service trade,establishment of commercial entities in the United States by TCM institutions,and personal development of Chinese acupuncturists in the United States:(1)At the national level: promote mutual recognition and cooperation of academic qualifications and licenses between China and the United States,reduce restrictions on TCM practitioners and acupuncturists outside the United States;train overseas TCM talents;promote the application of evidence-based medicine in TCM discipline,so as to fundamentally promote the melting of cultural barriers,improve the public acceptance of TCM and its medical status in the international community.(2)At the level of TCM institutions: according to the management mode of each state,analyze the key development areas,adjust measures to local conditions,and make specific analysis;We should build a unique TCM service to enhance our competitiveness in the market competition with local acupuncturists and Western doctors in the United States;We should make use of local resources to jointly run medical services and actively carry out business joint ventures and cooperation with local universities,research institutions,social organizations and enterprises;(3)Personal level: targeted planning according to local practice requirements is needed;In addition to medical services,the development of other types of TCM services trade such as training,cultural services,information services are also needed. |
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