We thank Albert Tay Beng Guan (Uphold rigorous safety standards for TCM too, Oct 20) for his questions on ongoing efforts by the Ministry of Health (MOH) to integrate traditional Chinese medicine (TCM) into our mainstream healthcare system.  

Patient safety, quality of care, and clinical- and cost-effectiveness are central to MOH’s efforts in this area. 

Randomised controlled trials (RCTs) are an important and rigorous standard of evaluating healthcare interventions. However, applying RCTs to TCM can be challenging due to its highly individualised diagnostic and treatment frameworks. While RCTs have been conducted on TCM and Ayurvedic medicine, other research methods like systematic reviews and real-world evidence studies also offer pragmatic and rigorous ways to evaluate clinical effectiveness without compromising our core principle of upholding patient safety. 

Integrative medicine is not a new concept, and is well-established in Europe and North America. Singapore is still early in this journey, learning from other jurisdictions and considering the totality of available evidence to determine how TCM can safely complement mainstream medicine.

The TCM Integrative Sandbox launched in 2025 across public healthcare institutions is a key step in this direction in developing our own evidence.

To further safeguard patients and support timely care, MOH is also studying whether accredited TCM practitioners, upon passing competency assessments, may order plain X-rays. This will let TCM practitioners promptly detect underlying conditions such as fractures, and decide whether TCM treatment is appropriate or immediate referral to a Western doctor is needed. Further details will be announced when ready. 

Western medicine and Chinese medicine are historically and philosophically different systems, each with its own approach to diagnosis and treatment. TCM’s centuries-long history of practical experience and observational data could complement contemporary research standards, while RCTs need not be the sole or mandatory benchmark in every context.

As Singapore pursues closer collaboration between the two, we should respect their different traditions and expand approaches that ultimately improve care for patients.

Head (Traditional & Complementary Medicine) 
Ministry of Health