By Merrily Manthey, MS

KENT MODEL NOW AT REDMOND CLINIC

Community Health Centers of King County "Clones" Original

A second integrative clinic has opened based on the landmark King County Natural Medicine Clinic in Kent, Washington. Citing patient demand, the Community Health Centers of King County opened their second primary care clinic using the natural medicine/conventional care model. The original clinic, hosted by Kent Community Health Center, has been open over two years demonstrating outstanding success in providing integrative health care to its patients. The parent organization intends to organize its remaining five clinics in King County to the prototype in Kent. For more information, contact the Kent Community Health Center, 253-852-2866.

By Merrily Manthey, MS

PEOPLE IN CLINIC ARE THE CATALYSTS FOR CHANGE

People who are committed and open-minded are bringing about the integration of natural medicine with allopathic medicine. So concludes researcher Amy Roussel, Ph.D., in her case study presented to the King County Advisory Board in November. Roussel is a social scientist employed by Statistics and Epidemiology Research Corporation (SERC), the Seattle-based research group studying the King County Natural Medicine Clinic. Formal release of her study is set for December 1997. This study is part of the research being conducted on the King County Natural Medicine Clinic project, studies which will include clinical outcomes is set to be completed late in 1998.

Roussel concludes the leadership, staff; and the patients in the clinic are making change happen. She notes "their commitment to the enterprise and ... open-mindedness to new options ... are facilitating integration." The SERC researcher farther points out that "in the ideal of health care as a patient-driven process, it is through their exercise of informed choice that integration can occur." (The Citizens for Alternative Health Care organization certainly knows something about this, as they continue to provide significant leadership to bring informed choice to the health care consumer.)

From the perspective of 17 staff members interviewed by Roussel, the clinic is making "significant progress toward achieving integration."

What is meant by "Integration?"

The concept "integration" was explored in this study by asking the participants, "What does integration mean to you?" Most respondents offered definitions that stressed one of three concepts: cooperation, collaboration, or choice.

The case study added other dimensions to the definition of "integration," which included communication, consultation, and crossover. Crossover meant whether providers changed "their practice by adopting the approach, orientation, language or values of another discipline; for example, allopathic providers employing more natural medicine techniques, or natural medicine providers essaying more biomedical interventions." One of the allopathic providers who participated in the case study said, "…Maybe now I do a little more preventive medicine than I'd do before, like recommending vitamin C and throat gargles for an upper respiratory intention. Maybe I'm not so quick to give antibiotics now."

The completed case study covers the initial start up period between October1996, when the clinic opened, to June 1997. The study was designed to understand the process of implementation and integration and to provide a meaningful context for the interpretation of the companion research findings regarding health outcomes and providers' practice behavior. Other goals included discovery of the links between structures, processes and outcomes; analysis of the barriers to and facilitators of integration; and to develop lessons learned.

Roussel interviewed clinic staff and included observations of activities such as retreats, education, training, and other exchange of information. One surprising aspect Roussel discovered was that people loved describing how much they had learned from this nationally watched integration project.

Achieving Choice Very Important

The researcher reported that the element of choice was a most important factor. A natural medicine provider was quoted, "...and some [patients] have even changed their minds later [like deciding that one way is too hard for them, or there are too many side effects]." Roussel concluded that most discussion of choice "was in terms of choosing conventional medicine or (emphasis added) natural medicine; only rarely was the option of using both modalities mentioned."

Patients actually surprised their providers. According to the case study, one allopathic provider said it was not easy to predict who was going to want natural medicine, "... sometimes they ask for it and you wouldn't expect that." An impressive additional note came with the observation about the patients in this particular clinic. It seems the most prevalent influence of the patients described was, "They inspire me ... I get life from them...." (11/21/97)  See article, "Two patient examples."