When I was growing up in India, there were homeopathic and Ayurvedic clinics (as well as Western medicine doctor's offices) on every street corner. People of all stripes, of all socioeconomic and educational backgrounds, sought out homeopathic and Ayurvedic care for everyday ailments such as coughs, colds, pain and allergies.
From my youthful and naïve perspective, it seemed as though this was the medicine of the people — given that health care was, and still is, a predominantly self-pay business in India. Many families had their own "family" homeopath or Ayurvedic doctor who might make house calls. For the low-income and indigent, these low-cost providers were often the only health care they received.
Fast forward a decade or so, when I came across the 1993 Harvard survey of the American public's use of complementary and alternative medicine. The results showed, among other things, that the majority of users were affluent, middle-aged white women, and that most services were paid for out-of-pocket. This meant that there had to be sufficient disposable income to access this care, leaving those without means unable to avail themselves of these often low-cost and low-risk modalities.
Of course, the irony was not lost on me. These "traditional" medical systems had become the medicine for the privileged few when, in fact, they could be an excellent adjunct and resource, given their generally lower cost, for low-income and indigent patients. Intrigued by this development, I wrote a column in 1999 for the November/December issue of Health Forum Journal ("Alternative Therapies for the Medically Underserved"), in which I showcased three unique organizations: the Lincoln Recovery Center in New York City; the Charlotte Maxwell Complementary Clinic in Oakland, Calif.; and the King County Natural Medicine Clinic in Seattle. Each organization was making some of these therapies available to all, regardless of ability to pay.
So, I was pleased to hear recently that there is now an organization that brings together these and other organizations with an annual conference, resources and networking opportunities to learn and share best practices. What began as a small group of members of the Society of Teachers of Family Medicine who were participating in monthly conference calls, became an organization called Integrative Medicine for the Underserved, according to its president, Rick McKinney, M.D. The mission, he says, "is to take this medicine out of the boutiques and into the streets."
The collaborative offers resources, advocacy and education to improve access to integrative medicine for all. In addition to monthly conference calls, it offers a toolkit, available on the website, designed for practitioners and teachers of integrative medicine for the underserved. Over the last five years, several thousand individuals and organizations have used the site, attended the annual conference and participated in the monthly conference calls, says McKinney.
McKinney is also the director of the Integrative Health Office at San Francisco General Hospital, which is beginning a pilot program to offer acupuncture to cancer patients. San Francisco General is conducting group medical visits for mind-body therapies in the chronic pain and spine clinics.
The lessons they learn, and those learned by the many organizations that are committed to creating access to these therapies for the underserved, will be valuable to all organizations wishing to do the same.
Sita Ananth, M.H.A.,is a Napa, Calif.–based consultant and writer specializing in complementary medicine and wellness. She is also a regular contributor to H&HN Daily.