TCM in Modern China: Hospitals, Standardization and Integration

Why this page matters

In China, traditional Chinese medicine is part of the public health system, not only an alternative option. That differs from the United States or Europe, where it is mostly private and often outside insurance. This page describes how the system is organized and how it came about. It does not say that being widely used in hospitals proves that a treatment works. For that, see Does TCM Work?.

A note on sources: most figures come from a 2016 report by China's State Council Information Office, and from a 2017 report from Chinese state media on licensing. These are government sources and are the most recent we could read. We report them as the government's statements. We could not verify newer national figures.

Policy since 1949

The government report says that when the People's Republic was founded in 1949 it made "uniting Chinese and Western medicine" one of its guidelines for health work. In 1978 the Communist Party transmitted a report on its policies toward TCM and the training of practitioners. In 1986 the State Council set up a relatively independent administration for TCM. In 2003 and 2009 the State Council issued TCM regulations and opinions on promoting TCM. [1] The Constitution states that the state promotes modern medicine and traditional Chinese medicine. [1] In 2016 a strategic plan for TCM development (2016-2030) made TCM a national strategy, and a draft Law on Traditional Chinese Medicine was submitted to the legislature in 2015. [1]

Independent scholars describe the path in more detail. A historian of Chinese medicine writes that in the early 1950s Chinese-medicine doctors faced restrictive rules, that this eased from the mid-1950s as the state promoted integration, and that by 1963 the institutionalization and standardization of Chinese medicine was complete. [2] The same chapter says the Ministry of Health in 1980 listed Chinese medicine, Western medicine, and their integration as the three pillars of the Chinese medical system. [2] The earlier history is in History of Traditional Chinese Medicine.

Hospitals, clinics and practitioners

At the end of 2015 the government report counted:

• 3,966 TCM hospitals, including 253 for ethnic minority medicine and 446 for integrated Chinese and Western medicine;
• 452,000 TCM practitioners and assistant practitioners;
• 42,528 TCM clinics;
• 910 million visits to TCM units that year. [3]

A later report from Chinese state media said there were 481,590 TCM practitioners and assistant practitioners in 2016. [4]

The report describes urban and rural networks that include TCM hospitals, TCM departments in general hospitals, community health centers, county hospitals and village clinics, and says TCM departments are encouraged in general hospitals. [3][1] It also says TCM institutions provided 15.7 percent of medical services in 2015, and that per-visit outpatient and per-capita inpatient expenses at public TCM hospitals were 11.5 percent and 24 percent lower than at general public hospitals. [3] These are the government's own figures. They do not compare patient outcomes.

Integrated care: what it means in practice

The government report says the state encourages TCM and Western medicine to complement each other, that modern medicine courses are offered at TCM colleges, and that TCM has been made available in the basic medical care system. [1] A historian adds a caution: practitioners of both TCM and integrated medicine usually use biomedical diagnostic methods and prescribe biomedical drugs. [2] For the wider picture of combining the two, see TCM and Modern Medicine: Integration.

Education, standards and medicines

The report says that by the end of 2015 China had 42 institutions of higher learning in TCM and more than 200 other institutions offering TCM programs, with 752,000 students, along with master-apprenticeship training. [3] A registration system for TCM drugs approved about 60,000 TCM and ethnic minority medicines, and 649 TCM standards were in place, with national technical committees for areas such as TCM and acupuncture and moxibustion. [3] For quality rules, see Chinese Pharmacopoeia and Standards.

The same historian describes Chinese patent medicines developing rapidly in the 1970s, with raw herbs increasingly made up into pills, liquids, syrups, powders, granules and capsules instead of decoctions. [2]

International role

The government report says China works closely with WHO and credits its own efforts for the inclusion of traditional medicine in ICD-11. [5] WHO says ICD-11 has an optional supplementary chapter, "Traditional medicine conditions", for dual coding alongside regular codes. [6] See WHO, ICD-11 and the International Recognition of Traditional Medicine.