One country : Two systems - the challenges of integrating Western and Chinese medical healthcare systems

The World Health Organization has emphasized the importance of the development of complementary and alternative medicine strategies and health services amongst its member states. However, Traditional Chinese Medicine (TCM), despite its long history of usage and practice, was left outside the mainstream in Hong Kong during the British colonial period, while Western medicine dominated the health care system. The role of TCM as a part of the Hong Kong health care system was not formally recognized until the handover of the city's sovereignty to mainland China in 1997. Although the government has reiterated its commitment to further integrate TCM with western medicine, the different sociopolitical origins and cultural perspectives within the different medical modalities raise many questions for successful integration. We have devised a "4Ps" model to assist in framing questions in developing integrated practice across the Western medicine and TCM healthcare systems, based on four domains: patients, price, professions and policy. For patients, we will describe those who choose alternative to allopathic care. Using their utilization profile, we will explore attitudes towards collaboration between TCM and western trained healthcare professionals. We will also describe the role played by price and payment systems and their impact on access to and quality of care, particularly the interface between private and public sectors. We will identify current successes and failures in the last 10 years and suggest which policy makers need to address to progress integration. In doing this we will draw on our current government supported policy research portfolio.