Acupuncture, a Way Out of Crisis? Paradigms in Health Care

Jun 26
4 min read

Updated: Jun 30

Inspired by Thomas Kuhn's The Structure of Scientific Revolutions

An intuition born from a book

Years ago, I read Thomas Kuhn's The Structure of Scientific Revolutions. It's a book that changes the way you look at medicine, at science, and even at a therapist's working life. Kuhn develops a simple but powerful idea: science doesn't advance in a straight line. It alternates between long periods of stability — what he calls normal science — and moments of crisis when the old ways of thinking no longer explain what we observe. It's in those moments of crisis that extraordinary science emerges: parallel, sometimes heretical ways of thinking that eventually offer a new framework — a new paradigm.

Re-reading Kuhn after years of acupuncture practice, an intuition took hold. What if Western medicine were going through one of those periods of crisis right now? And what if acupuncture — still often regarded with curiosity or suspicion — were not a medicine of the past surviving by accident, but a path arriving at exactly the right moment to help us think about what comes next?

The dominant paradigm and its cracks

Our modern medicine rests on a remarkable paradigm, inherited from the 19th and 20th centuries: the body is a machine, illness is a fault in the machine, and healing means identifying the faulty part to repair or replace it. This paradigm has produced miracles. Antibiotics, surgery, vaccines, medical imaging — the list is long and impressive.

But like any paradigm, it has its blind spots. And those blind spots are growing. Chronic illness, which now accounts for a majority of visits, resists the faulty-part model. Chronic pain, anxiety, exhaustion, insomnia, migraines, functional digestive disorders — none of these reduces neatly to an organ to repair. Care becomes less accessible, waits grow longer, costs explode. And many patients leave their appointments with a prescription, but with no meaning to make of what is happening to them.

These are, exactly, the symptoms of a crisis in Kuhn's sense: anomalies piling up, a framework cracking under its own weight, and a growing need for other ways of thinking.

Acupuncture: a radical pragmatism

This is where Chinese medicine becomes interesting — and not for the reasons usually given.

Acupuncture is often presented as an "ancient" and "mysterious" medicine. That's a mistake. Acupuncture emerged during the Warring States period, an era of violence and an urgent need to heal. It was built not in libraries but in bodies. Its central concern was never to be right about the nature of the body. Its central concern was always to be effective.

That's a major philosophical point, and it's what makes acupuncture especially interesting at a moment when our medicine sometimes seems more anxious to defend its models than to help people.

When an acupuncturist speaks of "fire," "Spleen deficiency" or "Liver Qi stagnation," they know — and the tradition has long known — that there is literally neither fire nor earth in the body. These are operational metaphors. Tools for thinking. Maps that help guide the clinical act. Chinese medicine, in a sense, integrated from its very origins what the philosophy of science took centuries to formulate: our theories are not reality, they are useful models. What matters is what they let us do.

This is, to my mind, a radical pragmatism. And it's precisely the kind of intellectual stance our medicine could learn from.

Two incommensurable paradigms — yet complementary

Kuhn uses a precious word for scientific paradigms: they are incommensurable. You can't really judge one by the other, because they don't ask the same questions, don't define the same objects, don't recognize the same proofs. Asking acupuncture to prove the existence of meridians with an MRI is like asking a poem to prove its truth with an equation. It's not the right tool for the right question.

This doesn't mean acupuncture escapes all evaluation — on the contrary, it is increasingly well studied, and its effects on pain, anxiety, migraines and insomnia are better and better documented. But it does mean we gain by understanding it within its own logic, rather than forcibly translating it into the language of another medicine.

And that's where I believe there is something freeing for our era. Many patients arrive at the clinic exhausted not only by their symptoms, but by the meaning that has been given to them — or refused them. "Your tests are normal." "It's in your head." "You'll have to learn to live with it." Acupuncture offers something else: a framework where fatigue, pain and anxiety find meaning, coherence, a story. Not a literally true story. An operational story, one that lets you act, understand, and reclaim your body.

Out of the crisis, upward

I don't believe acupuncture replaces modern medicine, nor that it should. When an appendix flares up or a heart fails, you want a hospital. But I do believe that in the zones where the dominant paradigm reaches its limits — chronicity, meaning, prevention, caring for the person rather than the organ — acupuncture carries an intelligence we need.

An intelligence of the model owned as a tool. An intelligence of the person before the diagnosis. An intelligence of the act that heals without needing to explain everything.

Kuhn teaches us that crises are never resolved by repeating, louder, the paradigm that produced them. They're resolved when parallel ways of thinking, long marginal, are finally taken seriously. Acupuncture is not a regression. Nor is it the single solution. It is, perhaps, one of the paths that will help us reinvent a more humane, more accessible, more pragmatic medicine. A medicine that remembers its reason for being is not to be right, but to help people get better.

That, at least, is the meaning I give to my practice. And it is, I hope, what you find when you step through the door of an acupuncture clinic: not an alternative medicine, but an alternative way of thinking about what it means to care.

If this reflection speaks to you, I extend it in a deeper second essay, "Effectiveness, the plate and the person". You'll also find these ideas at work in our articles on migraines and insomnia, where they take shape in the clinical encounter.

In the Plateau-Mont-Royal, we take the time to understand the person: a first visit lasts 1 h 30. Book an appointment.