LOS ANGELES -- The double identity of Chinese Americans affords them alternative perspectives on health issues that might not be readily accepted by the mainstream.

Tom Su, 45, a student of Chinese medicine at Alhambra Medical University, said, “From what I observe, unlike the Americans, the average Chinese would not readily go see a doctor when they are sick. They will either purchase packaged Chinese herbs or simply ask their families to send pills from China or Taiwan.”

Because Chinese herbs are available over the counter, many Chinese immigrants to the United States would prefer them to pharmaceutical drugs. Also, Chinese seniors are wary of Western medicine because they worry that drugs sold here commonly include toxic components.

Honeysuckle, Woad – But Not Tylenol

For example, medical references warn that acetaminophen (Tylenol), although safe and effective when taken in approved doses, can cause liver damage if overused, according to Shanghai-born physician Dennis Lee, in an article for WebMD’s MedicineNet.com.

Su commented, “Few Chinese would just go take Tylenol when they are down with a cold or fever—everybody knows it can poison you; woad, honeysuckle, mulberry chrysanthemum extract are their things. The theory goes, ‘If we can do it ourselves, why bother seeing a doctor?’”

Self-help has been a deep-seated tradition in Chinese culture. Because of that, hordes of dietary supplements and herbal products have emerged hailing from murky origins, but boasting effects as miraculous as the fountain of youth.

Taking up the lion’s share of Chinese newspaper advertisements, these supplements and herbs—uniformly labeled as “food” to avoid U.S. requirements that drugs go through extensive clinical tests—are consumed with enthusiasm and sometimes blind faith. They fuel and reflect an alternative health market rooted in oriental philosophy, oriental medicinal theory and practice, and self-cultivation regimens.

Many adherents to Chinese self-healing practices reside in the Vincent Lugo Park, area of San Gabriel, a Southern California community. Asian seniors there commonly dress in sportswear or casual clothing, and either solo or in groups, dutifully perform such morning exercises as Taichi, qigong, meditation or unnamed routines aimed at exchanging energy with trees and shrubs.

Tai Chi for Daisy’s “Frozen Shoulder”

Daisy, 58, a petite immigrant from Northeastern China, is a professional baker, who was forced to quit her job due to “frozen shoulders” (scapulohumeral periarchritis). Each morning she joins a Tai-chi group at Lugo Park.

A member of Daisy’s group known as an amateur Qigong healer and would emit “qi” once a week along the meridians in her back, shoulders and upper arms. Daisy explained, “His qi massages the same acupuncture points acupuncturists would use to promote blood circulation.”

Daisy does not use the pricey acupuncture clinics charging $50–$60 per visit, but frequents one of the oriental-medicine universities in Los Angeles, such as Alhambra Medical, Dongguk or South Baylo, which cost $10–15 per visit for outpatient treatment. They also provide a weekly free clinic.

Although these places are ideal for low-income people and those without health insurance coverage, few older Chinese people attend them because the treatments are done interns supervised by licensed acupuncturists. Chinese clients “do not want to be seen by inexperienced interns,” stated Qing Ma, of Alhambra Medical University.

Also, said Su, most Chinese herbal shops have licensed in-house acupuncturists offering their service at merely $15 per hour, so low-income Chinese patrons would rather go there.

Because of the close connection between traditional Chinese medicine (TCM) and Chinese philosophy, yin/yang theory in particular, the conventional image for a TCM practitioner is never that of the modern cold and tough medical professional, clad in white while oozing the smell of disinfectant.

Spiritual Sages

In contrast, a practitioner of Chinese medicine has often been seen as a spiritual sage, such as Confucian scholar, a Taoist cultivator, a Buddhist monk or a martial artist. The cultural stereotype of TCM favors a goateed, white-haired and learned healer, who spews Zen wisdom and radiates warmth. In this paradigm, credentials are not judged by formal schooling and licensing. Hu Naiwen, 70, is one such charismatic figure.

This revered Taiwanese doctor now teaches as a visiting professor at a few Northern California TCM institutes. On a sweltering day in August 2008, more than 200 people packed a room at the Chinese Cultural Center in El Monte, Calif., where Hu was worshiped like a guru rather than a doctor.

No one there cared whether Hu went through the licensing process dictated by the California acupuncture board. Those attending believed his fame alone warranted the handsome out-of-pocket sum they paid for his advice.

Chinese patients flock to effective TCM practitioners, such as Hu, who were formerly or even informally trained in Taiwan or Mainland China. Many of them are older adults and enjoy a trust that has helped foster a marginal yet vibrant market for senior practitioners of alternative medicine.

Legal action against doctors for medical malpractice is rare in Chinese culture. One of the reasons that Taiwan can maintain a National Health Insurance program, which some have hailed as a “Health Utopia” because of its wide and equal access at a relatively low cost, is that “medical disputes are rare in Taiwan,” according to former parliament member Shen Fu-hsiung, a physician.

Shen added that in contrast to the United States, “In case of malpractice or accident, the majority of patients would owe it to their fate rather than file lawsuits. Nor would a doctor who has lost a case suffer from hefty compensations.”

Malpractice -- U.S. Tendency to Sue Contagious

Tom Su of Alhambra Medical University, said the U.S. tendency to sue is “contagiously affecting American-Chinese.” He cited his mother’s case as an example.

Mrs. Su, 66, a TCM practitioner trained in Taiwan and having no U.S. credentials, is so well regarded for her accurate diagnoses that she has earned the affectionate title of the “Golden Hand” to signify her accurate diagnostic touch.

As a pastime, she sees patients pro bono at home in El Monte, Calif., giving away herbs to patients who cannot afford them.

According to her son, those patients are usually inflicted by the “weirdest illnesses regarded nontreatable by Western medicine” and come to see Mrs. Su as a last resort.

Tom recalled, though, that in this country, his mother ran into trouble with a woman patient in her 50s. “After taking my mother’s herbs for a week, [she] found that her breast cancer had reached stage III. Inconceivably, she blamed it on my mother and threatened to sue.”

Mrs. Su was both furious and felt powerless. Since then, Tom said, she has refused to see anyone but family members.

The official history of traditional Chinese medicine in the United States is short, and its integration and recognition has been bumpy, strained with cultural clashes.

Chinese Medicine in U.S. Since 1825

The popular version usually pins the introduction of acupuncture to the time when President Richard Nixon opened up relations with China. But the earliest documented Chinese herbalist/acupuncturist appeared in Philadelphia in 1825.

Since then, Chinese doctors treated patients in underground clinics and through referrals only. In April 1973, Nevada became the first state to legalize traditional Chinese medicine when half of the state’s legislators agreed to submit themselves to the needles of a Chinese doctor. Henceforth, they declared, TMC would be regarded as “a learned profession.”

In 1975, Miriam Lee, now a TCM pioneer in the United States, stood trial in a California court for practicing medicine without a license. Her patients anxiously filled the courtrooms to testify on her behalf. A year later California legalized acupuncture as a medical practice.

Nowadays, although it goes without saying that the majority of TCM practitioners would pursue licensing before first poking needles in patients’ bodies, it did not prevent some senior immigrants to practice or seek benefits from the underground alternative health market still active in many communities.

Mei Zhou wrote this article under the MetLife Foundation Journalists in Aging Fellowship program, a project of New America Media and the Gerontology Society of America.