The country's first publicly funded alternative health clinic suggests ways of treating old problems
by Steffan Sarter
Common Ground Reporter
April 1997, page 14, 15
Washington has become known nationally for its openness to natural healing alternatives. It was the first state that required insurance companies to offer alternative medical options for subscribers.
Now the nation's first publicly funded health clinic focusing on both conventional Western medicine and alternative approaches is open in Kent and attracting worldwide attention.
The King County Natural Medicine Clinic, which opened in October, is managed by Bastyr University with help from the private, nonprofit Community Health Centers of King County,which provides nurses and physicians, referrals, and administrative support. The new clinic focuses on providing an integrative approach to health care primarily for low-income people, immigrants, and refugees.
The project is being funded through a $1.2 million federal grant administered by he Seattle/King County Department of Public Health.
Its mission: to serve as a two year pilot project in which acupuncture is, naturopaths and nutritionists work under the same roof with medical doctors, looking not for which approach works best but for how traditional and modern methods can be integrated for the best possible treatment results.
"I think we've really started a revolution here," says King County Council member Kent Pullen, who, as council chair in 1995 and 1996, spearheaded the drive to place the clinic concept on the table. "Natural medicine really works with 95 percent certainty in many cases and at a lower cost with fewer side effects."
The facility has drawn worldwide media to Kent since it opened. A French TV crew was here in early January to produce a documentary on the facility, and Peter Jennings' World News Tonight team roamed the clinic's halls in late February.
While the Kent clinic has understandably garnered the international spotlight,another pilot project under way in north Seattle has gone virtually unnoticed. Nestled inauspiciously off Greenwood Avenue at 133rd Street is the Greenwood Park Care Center, where a similar experiment is focusing primarily on senior citizens.
Open since July 1996, the clinic offers occupational and physical therapy, craniosacral therapy, energy healing, somatoemotional work, acupuncture, acupressure, Tuina (Chinese massage), and yoga to both residents and nonresidents.
Jan Reed and Carol Williard, both physical therapists at the care center, began investigating alternative medicine in 1995. Their research led to meetings with insurance company officials. "They asked for an opportunity to show (insurers) what we could do in a geriatric setting," says Julie Liebo, the care center's administrator.
Nationally and in Washington State, physical and occupational therapists have the same prescriptive authority as doctors, and health insurers view them as part of the main health care delivery system. This is advantageous in bringing "fringe" therapies into a traditional setting like the care center.
"(A) lot of the alternative health practitioners have good training, but they don't have the diagnostic background that we have," Williard says. Like the Kent center, Greenwood Park has m.d. and nurses on site, "so we're more able to determine patients' needs," Williard adds.
Though somewhat different in their focus and setup, both clinics are providing groundbreaking information that may soon revolutionize the way medical care is delivered in this country. Two major factors are working to produce change.
First, conventional medicine is often expensive. Secondly, conventional or "allopathic" medicine may be less effective than alternative or "natural" medicine in treating long-term chronic medical conditions. Conventional medicine's strength lies in diagnosis, surgical intervention, and acute care, which can be very technology dependent and, by extension, expensive. By using the best of both conventional and natural medicine, patients may recover faster and at a lower cost than if only one option is available.
Large questions loom: How is society going to provide health care in general and specifically to the elderly and the poor, in the years ahead with Medicaid and Medicare in financial trouble? Who will be able to afford the cost of an average three day hospital stay in Washington state which, according to the Washington State Department of Public Health, is now slightly more than $7,500'?
And further, are there less costly and, in some cases, more effective treatments available than the ones medical doctors have generally relied upon for conditions such as hypertension, ear infections migraine headaches, intestinal problems, and osteoporosis (brittle bones)?
Those are the questions that both projects are addressing.
The initial spark that led to the Kent clinic occurred in 1995 when Merrily Manthey, a health consultant and member of both the Bastyr University and Harborview Medical Center boards of directors, decided she wanted to increase the availability of natural medical options at the medical center,
"I just kept thinking or the countless people who died because natural treatment wasn't available to them," she says.
Pullen, who says he's "always been interested' in natural medicine, had long thought about a way to improve medical options in the aftermath of failed federal attempts at health care reform.
Manthey approached Pullen first, who then "buttonholed" fellow council members, discovering to his surprise that "several of my colleagues not only were interested in natural medicine but were using it themselves."
In February 1995, a panel of alternative health care professionals, including Jonathan Wright, M, D., biochemist Jefferey Bland, Ph.D., and Joseph Pizzomo, Jr., N.D., Bastyr's president and co-founder, presented their case for a natural medicine clinic to the to council.
Later that month, council members unanimously approved a measure directing then County Executive Gary Locke to authorize a county-run clinic. It's the first time a municipal government has spearheaded such a venture, says Alonzo Plough, M.D., Seattle King County public health director.
Plough, who initiated an acupuncture clinic at Boston City Hospital before arriving in Seattle in 1995, says the clinic will provide more than a catalog of successful treatment options. "We're also looking at the diffusion of knowledge from natural medicine to Western medicine and back and forth," he says.
Once the county was on board, Manthey spoke to Kent Mayor, Jim White, who was impressed enough that he decided to convene a city task force to study the matter. By January 1996, Kent had proclaimed itself the natural health capital of North America. Subsequent discussions between that city and the county led to siting the facility in Kent, according to Manthey. To encourage natural healing options, the city provides employees with $1,000 toward natural medicine as part of its benefits package.
Naturopathic physician Jane Guiltinan, who oversees the natural medicine portion of the clinic, says she initially sat down with Marty Ross, M.D., who directs the conventional side. They discussed ways to integrate both approaches. "Partly from that ... we came up with what we call co-management protocols and guidelines," Guiltinan says.
Those guidelines require that patients see a conventional Physician first if they arrive at the clinic with any one of 16 conditions, including a host of acute symptoms, pregnancy, strokes, and fractures, among others.
For long-term conditions, patients have a choice of either conventional or natural care from the clinic's staff of two family practice doctors, a physician's assistant, an acupuncturist and traditional Chinese medicine practitioner, and a nutritionist.
Tracking the center's effectiveness is a crucial component of the project. The Statistics and Epidemiology Research Corporation, which has contracted with Bastyr to provide a statistical analysis of the clinic's effectiveness in treating mild hypertension, adult migraine headaches, and otitis media, a form of ear infection that affects children and youth, says Marcie Winger, Ph.D.,SERC's project director for research.
She says the three categories were chosen for analysis because both conditions are major public health problems, and SERC wanted to ensure that the study included a variety of age groups and a large enough pool of patients to make the study worthwhile.
The county has placed natural medicine high enough on its priority list to hire a full-time lobbyist. Nancy Weaver, the County Council's natural medicine coordinator, spends much of her time shuttling between Seattle and Olympia, Weaver says public financing of alternative medicine brings it into the open in a way that eliminates the inclination to be secretive.
"Traditionally what's happened, of course, is that most of us would go off to our (natural medicine) provider but wouldn't tell the family doctor what we were doing," she says. "Just to have both sides talking to each other ... it's really heading toward increased choice for patients."
Steffan Sarter is a freelance writer.