Entering the Kent Community Health Center reveals nothing particularly
unusual. The lobby and waiting area are not unlike what you might expect to find in any
medical clinic, clean but sterile. Magazines for waiting patients and their families are
as conventional as can be, Women's Day and the like. The building itself a one story
temporarily sited facility gives no clue of the unusual nature of what is happening
here. There is a sign however, which can be seen as you approach. the building. King
County Natural Medicine Clinic at the Kent Community Health center?" it reads,
listing participating organizations, Bastyr University, our local naturopathic and natural
medicine college, among them. Other participants include Seattle King County Department of
Public Health, the Community Health Centers of King County; and the City of Kent. With
federal and state funding, this collaboration has resulted in what is believed to be a
first in the entire nation: a publicly funded health clinic integrating conventional
(allopathic) and natural medicine. There in lies what is revolutionary about this clinic
and what makes it the focus of tremendous attention.
Opened in October of 1996, The Natural Medicine Clinic targets
low-income people, immigrants and refugees, making natural health care available to many
who were not previously able to afford it. Natural health care services offered include
naturopathic medicine, acupuncture, massage therapy, chiropractic care, stress management
and nutrition counseling. The staff includes medical and naturopathic physicians; nurse
practitioners, physician assistants; acupuncturists, and dietitians. Initial funding for
the Natural Medicine Clinic was provided by a one year $750,000 federal grant with an
additional $500,000 provided by the Washington state legislature for the second year of
the two year pilot program.
In part, the clinic was born of the 1993/94 discussion of health care
reform in this country. Many advocates of holistic health took notice that natural and
alternative medicine was not a part of the debate. Missing was any discussion of the
promise natural and preventive health care could offer to two overwhelming and related
aspects of the current health care system: rapidly raising costs and conventional
medicine's lack of success with degenerative disease.
Merrily Manthey was one who believed natural health care was usually
far less expensive than high-tech conventional medicine, and often more effective,
especially with long term chronic illness. Manthey was frustrated that the health care
debate virtually ignored making changes in the quality and type of health care. The focus
was on how to pay for the status quo. " It got me thinking about what would
constitute real health care reform," Manthey says.
As a member of the board of directors of both Bastyr University and
Harborview Hospital, Manthey was uniquely positioned to act. She first approached
Harborview with an idea to open a community natural medicine clinic, as one of its more
than 50 outpatient clinics. When Harborview didn't pick up on the idea, Manthey took the
idea out, eventually joining efforts with Joe Pizzorno, founding president of Bastyr.
"Dr. Pizzorno has a vision to provide scientific data to support
the use of naturopathic and natural medicine," said Jane Guiltinan, Medical Director
of Bastyr's Health Clinic, and Co-director for Natural Medicine at the Kent clinic. In
fact, Bastyr University was a recipient of one of the first National Institute for Health
(NIH) grants ever awarded for alternative medicine studies.. Bastyr U's new campus
in Bothell has an entire wing devoted to research.
Pizzorno wanted to set up clinical trials where the results of natural
and conventional treatments are directly compared with respect to certain medical
conditions. Manthey and Pizzorno found an enthusiastic ally on the King County Council.
Kent Pullen, Council Chair, spearheaded the effort on the Council for a publicly supported
natural medicine clinic that would include a research component.
Pizzorno got his chance to present his ideas to the full Council. Then
something revelatory happened. As individual members questioned Pizzorno, their questions
revealed that most all of them had availed themselves of natural and holistic
practitioners. This was an area of common experience the Council members had not
previously shared with one another. These local leaders were going public about their
experience with natural health care for the first time. Finding themselves in such good
company certainly must have been a moment of delight.
Not surprisingly, the Council's endorsement for a natural medicine clinic was
unanimous. In a time of tight budgets, funding was another matter. To lobby for funding,
and otherwise help administrate the creation of the clinic, the Council established a new
staff position: Natural Medicine Coordinator to the King County Council.
The Council appointed Nancy Weaver as the first Natural Medicine Coordinator, a
position unique in the country at any level of government. As a veteran legislative staff
member of 26 years, Weaver was not new to government, but was quite new to natural
medicine. "I had been asking council members about holistic and natural health
recommendations for my own health issues. I think that is they knew I might be
interested in this position," Weaver explained. "At the time, I was not a firm
believer in natural medicine."
Weaver worked with the King County Public Health Department to draw up an RFP (Request
for Proposals.) The RFP generated approximately two dozen letters of interest from
various health professionals and organizations. Eventually a number of these parties
collaborated and submitted three final proposals. Ironically, Harborview was a party in
one of the final submissions.
A screening panel, selected from around the country, reviewed the submissions. To
prevent any behind the scenes lobbying, the identity of the panel members was anonymous.
The collaborative team of Bastyr University; King County Community Health Clinics, a
private non-profit organization; and SERC, an independent health research organization,
submitted the selected proposal.
Although at the time of this writing the clinical trials have not yet begun, SERC will
conduct comparative studies around three common conditions:
Migraines, hypertension, (high-blood pressure), and otitis media (recurrent ear
infections). The studies will last about 18 months. There is also a sociological study to
track how the integrative medicine aspect of the Kent clinic is affecting the health
providers and their patients.
The Natural Medicine Clinic opened as part of the already existing Community Health
Clinic in Kent, and has created much change. To begin with the clinic building was
relocated, picked up and moved several blocks, to allow for the space for a temporary
add-on. The add-on -- a double wide mobile -- houses the natural medicine offices. This is
a temporary solution while an entirely new 20,000 square root building is being
constructed to house the Kent clinic. Scheduled to open in October 1997, the new facility
allows much more space for both natural and conventional medicine facilities.
.The formation of a. newly integrated clinic compelled some conventional health
providers in conjunction with natural medicine providers. These providers did not
necessarily plan to work in an integrated health care environment. Nonethe1ess, the
results, according to Tom Trompeter, Associate Director of the Community Health Centers,
have been mostly very positive. "The staff has been a really good fit," says
Trompeter.. 'They have worked well together. We are seeing providers consult with each
other and refer patients to each other." Despite some initial resistance; and even
the departure of one health care provider who did not take to the modifications, Guiltinan
essentially concurs, "It is working very well, really exceeding my
expectations."
According to Guiltinan, the medical doctors are learning from their natural health
counterparts and in some cases modifying the way they practice medicine; while, for the
naturopaths, the clinic patients themselves present the greatest need for change.
Until very recently natural medicine was generally not covered by insurance, and it was
never before subsidized in a community health care system. Thus natural health care has
only been. available to those who could afford to pay for it entirely out of their own
pockets. ." I think naturopathic providers are learning about working with poor
people and minorities," Guiltinan explained. "How do you ask somebody living on
$100 a week to buy $50 worth of nutritional supplements? It is forcing us to go
back to our roots, by trying to give medicine through food. Such as having a patient put
fresh garlic in food (rather than buying a garlic supplement) or teaching them to do
hydrotherapy (water therapy) at home."
So where is this innovative experiment in community health care headed? What happens
when the pilot program ends in June of 1998?
According to Trompeter, the King County Community Health Centers has an organizational
commitment to provide natural health services at all their clinics. Their participation in
the pilot project came along as the first funded opportunity to implement their plans for
natural medicine. They have every intention of maintaining the natural health component in
Kent, even when the pilot program expires..
Weaver feels confidant the King County Council will not only commit
dollars to complete the currently under funded program in Kent, but will further its
commitment to fully integrated health care. Weaver says, "Things are going
terrifically. The clinic is being extremely well received. An integrated system where
people are free to choose the kind of health care they use is where we are going."
Yet, the Kent clinic project may have a reach far beyond the community
health clinics and King County. It has already garnered tremendous media attention. CNN,
Peter Jennings' World News Tonight, and a French Public TV film crew have all visited the
clinic. All in all there have been hundreds of local, national & international media
spots focused on. the clinic. Health care professionals and public officials have
certainly taken notice. Manthey says, "I have had inquires about the clinic from all
over the country. I can't think of a single state I haven't heard from."
Guiltinan believes, "If this pilot project can demonstrate through
the studies that natural medicine can be as, or even more, effective than conventional
medicine, while avoiding the side effects, then this can be a model. It can revolutionize
the health care in this country."
To contact Merrily Manthey, email her at merrily@msn.com
