Birch suggests that in spite of much discussion, debate and conflict, several relevant issues remain unaddressed. Of these, the most critical differences lie at the level of the Eastern and Western knowledge paradigms. He proposes that the theories of acupuncture and East Asian traditional medicine stand on the same theoretical ground with advanced Western science. Apparent conflicts exists because there is a conservative tendency to insist on traditional Western scientific paradigms, ignoring or refusing to acknowledge the advances of twentieth century science itself. On the other hand, reductionism is the mainstay of modern Western biology, chemistry and medicine.
Western science is based on a cause-effect model where all things follow a direct causal logic.
He considers this issue to be the principal difficulty facing the traditional, the scientific and the integrationalist approaches to acupuncture and East Asian traditional medicine. If this is a problem for the scientific and traditional approaches, it is particularly problematic for the integrationalist school where the reciprocity of description is taken for granted. He suggests that if it should be possible to generate a larger world view that sacrifices neither the conceptual integrity and ingenuity of the traditional theories, nor the conceptual richness of modern science, enhancing both paradigmatic systems, one would have a model capable of carrying East Asian traditional medicine successfully and globally into the twenty-first century. He goes on to show that the Western paradigms are in a process of dissolution. Physicist David Bohm's has advanced a theory that the perceivable and measurable world, the world of our senses, corresponds to ripples on an ocean where the activities and rules of this hidden or implicate order have great significance relative to the observable or explicate order.