Yvonne Lau and Skye Sturgeon chat with Catherine Niemiec and Thomas Kouo on today's challenges in TCM education. (part 2)
The discussion of TCM Education continues with Yvonne Lau, Mayway President, and Dr. Skye Sturgeon of Mayway Herbs with Drs. Thomas Kouo and Catherine Niemiec, who are two prominent leaders in Traditional Chinese Medicine education. Thomas is the President of the Council of Colleges of Acupuncture and Herbal Medicine and the Vice-president of Academic Affairs at the Virginia University of Integrative Medicine. Catherine is the Vice-president of the Council of Colleges and the founder and President of the Phoenix Institute of Herbal Medicine & Acupuncture. (See complete bios at the end of the article.)
Discussion Participants:
- CN: Catherine Niemiec, JD, L.Ac.
- TK: Thomas Kouo, DAOM, L.Ac, Dipl.OM
- SS: Skye Sturgeon, DAOM, Quality Assurance Manager & Consultant for Mayway Herbs
- YL: Yvonne Lau, President of Mayway Herbs
Part 1 can be found here.
CN: So, if we can envision a future that really takes our medicine to the next level and it becomes more broad, it's more useful, and promotes health and prosperity, and happiness. They're all combined. It's all there because it's all energy. And the same thing goes for our students in schools. I find the ones that are successful out in the field started out in school. They came in with that positive attitude, and they carried it into their clinic with their patients. They had great clinic experiences because patients want some of that energy. So, I'm saying two different things--the energy of how we feel, but also the energy of where we want to go. Where do we want to step in and help and make a difference?
TK: Catherine, at your school, what are the commonalities for your graduates that you find in the really successful ones? Here, there's two things that I find each of them has; one is they dream. Second, they have a plan.
CN: And they have a vision. But it's really how they think and operate, because they're more self-aware, they can be a little more humble. Humility is actually very important. There's other things at work here, and so they're grateful. They're thankful. A lot of gratitude carries them very far, because what you think you attract. If you're grateful, you attract more things that you're grateful for. Because I've talked to them, and they come in and whatever happens, they always have a positive perspective on it. You know that student is going to succeed because they can get through life, so helping those students to see the effect of their own energy on themselves. their patients, their practice, everything, [is important]. And I think that's where meditation comes in. You tap into the flow of the Qi, and you see how life goes up and down, and you stay centered all the time. The Qi always brings you back to your center and to be grateful, and humble, so to speak, but that kind of quality.
If we can foster that in our schools, we'll make solid, strong practitioners. Many of our students are re-career students, and so they have some experience, and they get it. Some new students come in and we have to help them because they've come from the generation where the phone and the computer gives instant answers, and life and healing with what we do isn't like that, and they have to work at it. They have to do critical thinking. And they're not used to the heavy labor that some of the earlier generations had to do. We're dealing with some interesting generational paradigms that are different than what we're used to, and having students go through school that way and having them stay engaged in class, much less become a solid practitioner. There's no easy path. You still have to climb up the mountain.
YL: So helping them understand that is huge. How do you teach that? Everything you said really resonates.
CN: Number one, our message team has to be there, and we do rely on our faculty to say that. But it has to be kind of a universal message that this wisdom and medicine of ancients didn't come easy. They all had to do their work--you know, wax on, wax off.
YL: Definitely--or carrying buckets up the hill.
CN: Exactly. So, our duty as schools is to help them see that piece. It's not just giving the academic knowledge or the experiences, they have to think like a healer in this medicine, and that comes differently.
TK: Humility is a word that I love. I find it extremely challenging. It's difficult for us, because, on the one hand, we are teaching people to be good in business. Business and humility is not impossible, but it is difficult, and it is a very evolved person who can be at the highest level of business success and be humble. That's not something that we can teach. It's something that you have to grow into or become. The concept of humility in the era of social media, in the era of marketing, and in the area of competition is so many things working against us. I just sit there and think how difficult it is for us to try to have people that will be favorable in competition, be favorable in business, be confident in these areas that are not always areas of strength for the people that are attracted to our field, and as you said, also be able to grow into the true meaning of that word. It's such a beautiful, difficult concept, and yet so worth it. I agree a hundred percent with what you said.
CN: Humility is part of being compassionate, and being compassionate means being authentic in yourself, which again means having some humility around you, that you love and forgive yourself. Then you can be that loving person to other people, and loving in the workplace, or in the school place, and everything else. You know, real love is really all about compassion, and it's not easy, because we're always stressed and doing other things. But if we understand that someone who's negative or attacking, or running away or hiding, they're empty and afraid. They're drowning essentially, and then you can have compassion for that person, and that it's not about you. It’s their own stuff, but they need help. So, when you can reach out to that and get beyond that, that's healing. And quite frankly, that's what speaks for our medicine. Because the medicine can do various things, but if it isn't accompanied by that humility and compassion, it's not delivered with the right energy. And that energy is just as healing as our tools, and so to create practitioners who can be mindful and fully present, that's part of it. And quite frankly, we need that in all aspects of our business and everything else, because solutions will come, and collaboration comes.
SS: So, success can be defined many different ways. Obviously, you don't have to be financially successful to be a wonderful acupuncturist.
CN: But if you're a wonderful acupuncturist, you have a much better chance of being successful because people come to you because of you.
TK: Do you find any difference between this concept in terms of practitioners of acupuncture versus those that practice also herbal medicine, or practice primarily herbal medicine? Or do you think it's the same?
CN: I'm fond of herbs--I find them like little personalities that come together. And you need more knowledge or awareness or focus on internal medicine and diagnosis becomes even more key. [With herbs] you're affecting the body in a way that’s harder to fix. If you messed up, it takes more time, whereas with acupuncture you can almost fix it and adjust your treatment. You need to know enough to do both, but because the herbs have so much to them, you really have to get a handle on the herbs and the diagnosis, in my opinion.
TK: Although I think Acupuncture and herbal medicine work in the same way, it's about the relationships, the combining and how they work together. I think there's something about that concept, particularly in herbal medicine. Because as acupuncturists, a lot of times we start thinking in terms of isolated points and point functions, whereas in herbal medicine, we don't practice in mostly single herbs. So, it's mostly about relationships and dosage, the synergy and how that communication makes an effect within a system. It doesn't necessarily have to be, but I feel like it typically is a different mental process that herbalists go through than an acupuncturist. And I'm curious as to what kind of effect that makes on one's approach to oneself as a practitioner of either herbs or acupuncture. I don't have an answer to that, I'm just curious.
CN: You're making me think, too. So, acupuncture, I think you can get to the level where you're looking at the relationship between those points, and then the impact on the person. And the same thing with herbs. Herbs are like groups of people and how they work together, and relationships. I think herbs are really interesting that way.
YL: Well, I'm definitely biased for herbs, but I totally agree. [Herbs] have a depth to them. And because you take it into your body, it just has a different intimacy level when it comes to being treated.
CN: I like that. You are taking energy into your body differently, right?
YL: Right? And acupuncture by itself, is being watered down or encroached upon. And I've heard acupuncturists being called just technicians and that's really insulting. But in a certain way, mechanically, that's true. So sometimes I think herbal medicine is the way to save our medicine--to show the power of it by taking it beyond needles.
CN: Yeah, that is a way. And it's all about branding, too. Again, because you describe the artist that is creating an herbal formula that is designed to address this, this and this and work together. And I know that happens with acupuncture, too, the mindset that goes behind it. And that's where we have to differentiate ourselves with others who are using the needle. Again, how we market that and sell that and brand that to the public
YL: So whose responsibility is that? That's the million-dollar question here.
CN: The marketing committee of the Council of Colleges. I'm just kidding, but we have to get on the same page, because if we want to put that brand out, social media can do it for you. But it'd be nice if we could repeat the same message in various places from different people, and then we can get it out there, and we can get somebody else to acknowledge this benefit that we offer. And the ones who are trained are the ones who should deliver because we know what the heck we're doing.
YL: Isn't the Council [of Colleges] part of the newly formed group that includes the ASA and other organizations?
TK: The Coalition is what you're talking about, which brings [together] the four pillars of our profession--the Council of Colleges, ACAHM, the accreditor, ASA, the national organization and NCCAOM. Essentially, we have the Executive leadership for the Council, myself, Mina Larson from the NCCAOM, Olivia Shu from the ASA, and Mark Mckenzie and John Yu from ACAHM. We do meet monthly. The main thing is the acknowledgement that the different stakeholder organizations of our profession need to communicate, and we need to come together, and we need to have a singular voice in a singular movement. I think that the coalition has been very important for that. It gives our profession another hub for understanding where things are coming from, and where the momentum essentially starts, right? Hopefully, that will continue to grow and become more and more effective. Already we're seeing some really important things come out of the coalition.
SS: The Coalition may want to include members of the suppliers or industry, because we are intimately involved with obtaining the herbs, the processing, the creation of the formulas.
TK: Our Coalition has contacted the Vendor Coalition. All of us recognize the importance of the vendors, not just because of the supplies that they provide, but because the people involved, like yourselves, are some great minds, great professionals, and really important for our profession. So certainly, we have to unify.
CN: On that note there used to be an agency or a group that was all the licensing boards executive directors, the regulatory, and they would come together so they could communicate and help. So, if we're going to protect herbs, which I think we should, bringing all the manufacturers, the regulators, and the training, the educators together so we can really be on the same page.
TK: It's difficult, because, as you said, Catherine, we have certain states that require herbal medicine education. We have others that do not, some [where] it's totally unregulated, some that are very highly regulated. If we could somehow standardize that, maybe by generating a model practice act as a standard for our profession, maybe that could help push us in the right direction
CN: On that note, I can put this out there as an idea. When I first started this school, because I was the herbalist, I wanted to have a standalone herbal program like a pharmacist, so to speak. The accreditor said, no, we don't have that kind of thing, you have to stop, because only acupuncturists can do that. But I would love to see someone who's trained in the theory, the diagnosis and the herbs, and not necessarily, maybe, have a little bit of knowledge of needling, but they don't have to needle. They can just do herbs, because that's what they love. I think that degree needs to be developed.
SS: My herb teacher when I went to school, he was only an herbalist, had only ever been an herbalist, and when he came to the United States, he had to study acupuncture to get a license, to be an herbalist.
CN: That needs to change, in my opinion.
TK: You’d have to set up new licensure, so it's a lot of work.
CN: Well, right now they're not regulated so you don't have to be licensed. Some people kind of like that. Yeah, it depends on the state. We don't have unification of the concept of whether or not schools should have to include herbal medicine in their programs.
TK: Here in New Jersey, you do not have to be an herbalist to be an acupuncturist. And so again, most States that are like what we have here in New Jersey will automatically separate it out. You can have just an acupuncture program and then add herbs if you want. What we find is that many people are opting just for acupuncture, a 3-year program versus the 4-year acupuncture herbal medicine program. Does that ultimately hurt herbal medicine practice by separating it out and giving the option of taking [out] a big part of what our medicine is? One being based in physiology, one being based in in meridian system. Which are two sides of the coin. Both legit, but different. I've always wondered whether or not that's something that our profession should look to do, whether to say that herbal medicine is part of acupuncture with a big A, and therefore needs to be part of our programs, regardless of where your state stands on that.
CN: Well, it is part of the medicine. It's the same energetic concepts and diagnoses and everything, and the knowledge of each helps each other. Having room for people to practice one or the other if they resonate that way or both. It's just what do you like to play? What toys do you like to play with?
YL: Right, I think it depends on what you're trying to treat, and which would be the best tool?
CN: There are many more tools and many together, or some individually, can work because we could get a lot more involved in body work. We have an association for that.
TK: The biggest thing that herbal medicine training gives our profession is the understanding of treatment strategy, and the treatment is just whatever modality you want to use. But in terms of understanding patho-mechanism, understanding that treatment strategy, is really expanded for the acupuncturists that have studied herbs--their acupuncture changes because of their understanding of what they need to do and how to get it done. The understanding of treatment strategy is still limited, and when you learn the herbs all of a sudden that world just opens up a lot, and I feel that you become a better acupuncturist, even if you don't want to practice herbs. Just learning the herbs changes that part of the clinical process, cognitive process.
CN: It's good to be aware of other health professions, in integrated medicine or integrative medicine. My teacher said, you can do everything with herbal medicine, and the acupuncturists say you can do everything with acupuncture, and I think that's possible quite frankly.
TK: Can you actually create anything with acupuncture?
CN: It might take longer. Teachers would say this-- a really skilled acupuncturist could do amazing things that herbs couldn't touch and vice versa.
SS: I would say that acupuncture can create change.
TK: It can create change, but it creates change by moving things around rather than [create] substance.
SS: Well, form follows function. So, if you create change inside of the body, how is that change manifested? There have to be changes physiologically to take place. So, you can give signals to the body through nerves or through changes in the blood, or whatever, using acupuncture needles. It's possible to create in that way, and it might not be as fast. But I've seen acupuncture create change in a second.
CN: Yes, herbs and food can make change. Just look at how we gain weight and lose weight. There it is. There's the change. So, again, the practitioner is the key. Who can see what needs to happen, and the possibility of what could happen and get gets the patient there, right? And so, they may use one or more tools, and the more tools they have the better.
SS: It's a collaboration between the practitioner and the patient because the patient has to comply with the changes the practitioner is suggesting. So you have to be able to create in the patient-practitioner relationship, a partnership that will affect changes, because I can tell somebody you need to lose weight, but that doesn't make it happen, and you can't really cure things unless the people are willing to take the herbs. Submit to the acupuncture, make changes in their diet, lifestyle, exercise, all these kinds of things.
TK: Catherine, what percentage of your students do both?
CN: Maybe half. Now we have the doctorate and that helps. So, we have the doctor of acupuncture, doctor of acupuncture with herbal medicine, master’s of acupuncture, master's with herbal medicine, and it just depends. Some of them get their license and then they come back to learn [herbs], versus simultaneously. We just give a lot of options because everybody's life is a little bit different. And we try to support that whenever we can.
TK: Certainly, there's a large contingent of people who either don't do the herbs or like you said, may delay it for later. Kind of thinking about how to encourage people that are interested in our medicine to continue to study and practice herbs, and even those that study sometimes don't practice [it]. That's a huge challenge that's been on my mind, how do we? California and other states require [it] so people coming out of there will at least study it. But for all the rest of us how do we not let our herbal medicine programs start to fade because people are not wanting to do the extra schooling?
CN: Well, we owe it to ourselves and them to get way more excited about herbs and what it can do. Just the knowledge of it can be daunting, and I think the better we can explain it and have them enjoy it [the better]. There's another business opportunity for somebody here, because there's different bars. They're putting all these herbs and adaptogens into little sparkling drinks. And I think there needs to be more of that available for people to do socially. And whether it's a bar or a product or something, now's the time for that, because people are cutting back from alcohol, but they still want to feel something or think that they're doing something good for their body. And there's an opportunity there.
TK: I think we need a huge publicity hit. Right now, there's that whole thing about taking Thimerosal and Mercury out of vaccines. So okay, take it out. What are you going to put in instead? Why don't we put ginseng in, ginseng sparks the immune system. Why not see if that will work in this kind of medium and if it does, what huge publicity!
CN: Healthier and safer vaccines would be.
TK: Exactly. It's not that the medium is evil. It's the fact that you have a toxin. And whether or not that toxin is at levels that are causing things, we don't know the answer to that yet, but certainly, if that's the problem, then take the toxin out. But then it doesn't work theoretically because you don't spark the immune system. But what if we can spark the immune system in another way. We know that things like Ren Shen does spark the immune system. I don't know the answer, but could it work? That might be something we could...
CN: Research to see what it does.
TK: Yeah. So, something like this [will] make a huge impact and might draw people into Chinese medicine.
CN: Okay. So going back to my idea about [where to put] this medicine, I'm thinking restaurants, hospitals, assisted living, the food, energy, our medicine should be in those places. I mentioned social drinking. I want to see an herb bar. I think that'd be fun, or tea houses. Yeah, it's time our medicine steps up. Not just medicinal health care, but we can do it in other places, throw in some auricular acupuncture, get the whole emotional piece and psychological piece going. It's not just the medicine; it's the way we think about it. It's the energetics. It's the Qi. Let's get it out to all these other places so we can own it a little bit more.
TK: I remember in San Diego there was a soup place. Your soup was very tasty, but it also had certain herbs in there and I thought what a great idea--we've got to make this into a chain.
YL: I have to tell you some ancient history. In about 1983 or so, when we were still a retail shop in San Francisco, Chinatown, we rented the restaurant next door, and [opened] an herbal restaurant. It [had] herbal soups, tonics, dishes, and desserts. My sister and I waitressed– [untrained] teenage waitresses, unfortunately.
CN: Got your training there.
YL: Yeah well, it lasted I think, three years. I think the idea was before it's time. And most people in Chinatown knew how to make their own soups.
CN: Alright! But it might be time now.
YL: It might be time!
CN: I've seen adaptogens and other things in sparkling water drinks. Yeah, alcohol alternatives-- that's where it's headed a little bit.
YL: Well, that does make it more palatable, especially for the millennial generation and younger.
CN: Yeah, they want to be healthier, too.
SS: Bill Brevort of Jade Pharmacy used to make just what you're talking about, Catherine. You would go to the Natural Foods Exposition in Anaheim, and he did this to me. He saw me walking by, and he grabbed me by my jacket and says, “Come over here, you look burnt-out to me”. He takes a plunger, and he plunges two shots into this liquid and pours some sparkling water and hands it to me. I drank it, and I was like, “Wow! That was wonderful. What was that?” He had eight different ones for different conditions and made them into spritzers.
CN: I remember that line. I don't know what happened to him, but I like that stuff I was envisioning. I look forward to hearing from anybody who wants to make some change. Let's head in the positive direction.
SS: I liked your message there about the positive. You focus on the positive and that way you create a good change. You don't know where it's going to go, but at least it's positive. I think this is a good plan.
YL: I'm grateful to all of you for your time and insights. It was an amazing conversation--wonderful, so valuable. Maybe it'll spark some thought. Maybe someone will open a bar somewhere in their town. That would be amazing.
CN: It will grow the medicine. It's going to eventually trickle down to the schools and someone might want to go. Oh, I want to study this. You have to do various things to help build it into the lifestyle. And it's a healthy lifestyle and a positive.
YL: To make it mainstream like you're saying. [But] I understand Thomas's protectionism because I feel that to a degree, too. This medicine is kind of sacred in a way. It's our heritage, but at the same time I totally get it. We should make it palatable, and acceptable, really integrated into our society and into mainstream thinking and culture because we don't want to say “the other” or “the alternative”. We want to be part of it. It's a delicate balance.
SS: From its origins. It evolved to be what it is now. And it's going to continue to evolve. And we're going to play a role in that.
CN: That's it. We're building the future. And we have to let go of what it can ultimately look like because we can't control everything. But if we can put the right intent and envision what we want, somehow the universe makes it happen. So, let's start. Go!
Participant Bios
Catherine Niemiec, JD, L.Ac.
Catherine Niemiec obtained her juris doctorate in law from University of California-Hastings after receiving her undergraduate training at University of Arizona. While working as a litigator and later as director of a national bar review company in the San Francisco Bay area, Catherine was introduced to Acupuncture Medicine to address repeated bouts of bronchitis. After a Chinese herbal tea cleared her symptoms within minutes, she was inspired to study the medicine. Returning home to Arizona, she helped establish the Acupuncture Board of Examiners and the first medical school of Acupuncture in Arizona. The Phoenix Institute of Herbal Medicine & Acupuncture (PIHMA) is now in its 29th year offering 4-year Masters and Doctorate degrees in Acupuncture and in Herbal Medicine. Catherine has also served on several boards and commissions, including serving as:
- Chair, Commissioner and Site Visit Chair for ACAOM
- Vice-President of the Council of Colleges of Acupuncture & Herbal Medicine where she still serves on the Board
- President and Board member of the Arizona acupuncture associations over the years
Thomas Kouo, DAOM, L.Ac., Dipl.OM
Dr. Kouo currently serves as the Institutional Vice-President for Academic Affairs and New Jersey Campus Director for the Virginia University of Integrative Medicine (VUIM). He is a former Academic Dean at both VUIM and the Eastern School of Acupuncture and Traditional Medicine. He is a sought-after lecturer on many topics in acupuncture / herbal medicine, and teaches in several Doctoral programs around the country. He has served as a long-time accreditation site visitor for ACAHM. He has just completed editing and writing the forward and afterward for Giovanni Maciocia's The Psyche of Chinese Medicine, 2nd Edition with a planned release date in early 2026.
Thomas is the current President of the Council of Colleges for Acupuncture and Herbal Medicine (CCAHM) and former Vice-President representing the Council on the AHM Coalition, the AIHM, IHS, and the SAR. He is a past chair of the CCAHM Herb Committee and currently serves as the co-chair for the Academics Committee. He was able to participate in many national initiatives including the latest NCCAOM Job Task Analysis and task force for the BLS Acupuncture Designation review.
While serving as Academic Dean and Chair of the Herbology Department at the Virginia University of Integrative Medicine (VUIM), Dr. Kouo has led the university through the ACAHM initial accreditation process in March 2015 and the institution was awarded the maximum years of initial accreditation. Prior to VUIM, Dr. Kouo served as Herbal Department Chair for Pacific College of Health Sciences in San Diego. He taught in both the Master's and Doctoral programs while also serving as a Clinical Supervisor. A graduate of the Master's and Advanced Practice Doctoral programs (DAOM) at Pacific College, Dr. Kouo has practiced Acupuncture and Herbal Medicine in California, Virginia, and New Jersey.
Skye Sturgeon, DAOM
Skye Sturgeon, DAOM is the Quality Assurance Manager and Special Consultant for Mayway, USA. Skye was the former Chair of Acupuncture & East Asian Medicine and core faculty member at Bastyr University, core faculty member and Faculty Council Chair at the American College of Traditional Chinese Medicine, and President and Senior Professor of the Acupuncture & Integrative Medicine College, Berkeley. Before making Chinese medicine his career choice, Skye held various positions in the Natural Foods Industry for 12 years and prior to that was a clinical biochemist and toxicologist.
Yvonne Lau, Mayway Herbs President
Yvonne Lau has been the President of Mayway Herbs since 1997 and has worked in the family Chinese herb business since childhood. She first visited China in 1982, and still travels there annually for business and pleasure. She has had the good fortune and honor to work with many people both in China and the US who are passionate about Chinese Medicine and about herb quality.
Yvonne has also been active as the Vice President of the Chinese Herb Trade Association of America since 1998, a trade group founded in 1984 representing over 300 Chinese herb importers, distributors, and retailers primarily in California.
She chairs the Regulatory Compliance Committee for the Association, and in this role has lectured about Good Manufacturing Practices and best business practices, as well as organized and moderated meetings between regulatory agencies and the Association.