DOCTORS GENERALLY have no qualms referring their patients to colleagues with special expertise. But it's a rare physician who suggests a consultation with a Chinese medical practitioner. Donald Li Kwok-tung, a specialist in family medicine, is one. 'Orthopaedists can send patients to see physiotherapists. I don't see why family doctors can't work hand in hand with Chinese medicine practitioners to help the sick,' says Li. Although there's now more scientific interest in deriving drugs from traditional herbs, the medical establishment remains wary of Chinese treatments. However a small group of doctors, such as Li, are championing applications that were once anathema to western-trained physicians. Li says his embrace of traditional treatments is in line with the holistic approach that family doctors take in health care. Although Chinese medicine is based on very different concepts from western systems, he says it has a role in improving patients' well-being, especially in dealing with ill-defined, complex conditions such as chronic fatigue syndrome. Li extols traditional medicine's diagnostic method of examining patients' pulse and features as offering more attention than the typical examination. While western-trained doctors usually spend less than 10 minutes checking a patient with various apparatus and jotting down notes, he says, Chinese medical practitioners are more thorough. 'While examining the pulse, they spend more time chatting with patients about their problems. This is a good way of drawing out the person's medical history. It also helps build closer doctor-patient relationships, which is what family doctors try to do,' Li says. Leung Ping-chung is another advocate of Chinese treatments. Since retiring as professor of orthopaedics and trauma medicine at the Chinese University two months ago, he's volunteered his services as director of the university's Institute of Chinese Medicine. In addition, he serves as the secretary of a consortium of local universities to study and develop Chinese medicine. Having a father who was a Chinese medical practitioner fuelled Leung's abiding interest, but it wasn't easy pursuing it in practice - the subject was regarded as taboo when he was a junior doctor. 'Even when the Chinese University opened its medical school in 1981, the dean issued a warning: 'Whoever wants to get involved in Chinese medicine in the medical school, get out of my sight',' says Leung, who learned from his father while continuing his orthopaedics training. 'At the time no one dared to touch the subject except me; I was studying it underground,' he says. 'There were no competitors, which gave me a chance to establish a superior position in Chinese medicine [at Chinese University].' To ensure standards in Chinese medical practice, the government set up a registration system for practitioners after the handover in 1997. Since then, 5,000 people have gained registration. Nevertheless, most local hospitals and doctors are still reluctant to incorporate traditional Chinese applications into standard treatment, unlike mainland hospitals, which use Chinese as well as western methods. Physicians such as Leung maintain that each system has its advantages for treating different ailments. In some cases, they may complement each other, says the orthopaedics specialist who still swears by his father's flu prescription. Generally, western therapies aim for immediate impact, which is preferable in acute cases and those requiring surgery, Leung says. But conventional ways of treating cancer - by surgically removing malignant tissue or killing the cells through chemotherapy and radiation - have limitations. Patients still suffer relapses, 'so we need to find ways to let them live with their cancer cells, such as by controlling their growth', he says. Chinese medicine with its long history may hold clues, especially in the use of prized herbs such as ginseng and lingzhi. Leung cites as an example ancient medical literature describing symptoms such as extreme thirst and 'sweet' urine. 'That obviously depicts diabetes,' he says. 'There are also [descriptions of] cancer-like symptoms such as lumps and extreme pain in the sinus and other passages.' Veteran cardiologist Tse Tak-fu says patients will benefit if physicians can tap Chinese as well as western learning. 'It's common for Hong Kong families to take Chinese medicine for diseases ranging from flu to cancer. Patient will resort to it anyway, whether their doctors like it or not,' Tse says. 'Why can't we be more open and try to learn more about Chinese treatments, at least to have some knowledge about different herbs?' Statistics back Tse's argument. A government household survey in 2002 found that about one-fifth of consultations sought every month were with Chinese medicine practitioners. And a Labour Department poll the following year found that of 2,769 people injured at work, one-third sought similar treatment. Tse runs a busy practice, but he found the time to qualify as a registered Chinese medicine practitioner - after 10 years' hard work. It took determination and enthusiasm to see patients during the day and attend classes after work. 'Those 10 years were a long time. I often had to wake up at 4.30am to study. But I think the effort is worthwhile since my patients can benefit.' Tse doesn't give Chinese herbs to his patients, but they show him their herbalists' prescriptions. It helps avoid prescribing contra-indicated drugs, he says. Meanwhile, general practitioner Leung Koon-chit has recruited a locum for his clinic so he can undertake a practical stint at a Guangzhou hospital. The experience is part of a Chinese medicine programme he began at the Baptist University six years ago. 'The longer you practise western medicine, the more limitations you see,' says Leung, who will complete the programme in March. He argues that while conventional pharmaceuticals yield immediate results for brief periods, they aren't suitable for treating non-life-threatening, but debilitating conditions, such as arthritis, sleeping disorder and eczema. George Lau Ka-kit, a professor of hepatology at the University of Hong Kong, can vouch for that. To control his eczema, Lau takes a Chinese herbal concoction while applying a liniment prescribed by his dermatologist. The combined therapy has worked well, he says. The liver specialist had been reading up on Chinese medical philosophy and the results fuelled his interest. That some remedies taste good adds to the appeal. 'I enjoy delicious meals, so there are double benefits if dishes are both mouthwatering and have health value,' says Lau, who feels more energetic after drinking Chinese herbal soups. More hospitals now provide Chinese treatments at out-patient clinics, but only two have extended the service to their wards. In March, Tung Wah Hospital introduced Chinese treatments to convalescing patients while Kwong Wah combined western and Chinese practices in some wards. William Ho Shiu-wei, chief executive of the Tung Wah Group which runs both hospitals, says doctors' closed mindsets are a challenge, and they must change with the times. Western-trained physicians are under pressure to learn about alternative treatments to cater to patients' needs. Doctors should know enough to respond to patients' questions, Ho says. However, private hospitals are unlikely to incorporate Chinese therapies for legal and practical reasons, at least in the short term. Registration rules restrict the institutions to western practices in their wards, says the Hong Kong Private Hospitals Association's chairman, Alan Lau Kwok-lam. Besides, doctors trained in western medicine may have difficulty handling Chinese treatments, which involve disparate clinical management, Lau says. 'In western medicine, we have a protocol to standardise the diagnosis and treatment. But different Chinese medical practitioners may have their own prescriptions for patients so it would be difficult for doctors to manage.' However, such challenges haven't dampened the desire among doctors such as Leung and Lau to bring Chinese medicine into the mainstream medical system. 'Instead of differentiating between western doctors and Chinese medicine practitioners, I hope there will only be one profession called doctors - someone who can treat patients with their hearts and skills, regardless of their ways of treatment,' Lau says.