Traditional medicine, including acupuncture, herbal remedies, massage, homeopathy, apitherapy (the medical use of honey bee products), ozone treatment, and exercise such as tai qi and qi gong, has been formally incorporated into Cuban healthcare practices for more than 40 years. Medical students study acupuncture in China and nurses are also highly trained to perform acupuncture, moxibustion, and cupping. Physicians receive specialty training in acupuncture in Shanghai. None of these forms of treatment are considered "alternative;" they are all completely incorporated into the fabric of the Cuban healthcare system. Patients and their providers determine which forms of healthcare are preferable and most appropriate for them. Treatment becomes a seamless blend of whatever approaches are selected.