Monday, April 23, 2012

Group treatment makes acupuncture more affordable for patients

As our clinic here in Iowa City expands, we are in the early stages of finding ways to serve a broader community - and to make acupuncture more affordable. Many patients at Health On Point are either students or have health insurance that doesn't reimburse for treatments. Please read the article below. It demonstrates how one acupuncturist solved this issue. What do YOU think? Would a group acupuncture treatment be of interest? Let us know!

Acupuncturist Jamie Starkey inserts a needle into Jeff Husney's
forehead in the shared acupuncture room at the Cleveland Clinic.
CLEVELAND, Ohio -- Treatment for Jeff Husney's head and neck cancer made him a survivor but diminished something many of us take for granted -- the ability to eat.
The radiation aimed at the cancerous growth on Husney's tonsils left collateral damage in the form of compromised salivary glands. That, and the post-surgical scar tissue that built up around his jaw, made chewing and swallowing hard for the past four years -- and doctors told him he'd probably have to live with that.
Difficulty chewing and digesting food can be common for people who have been treated for head and neck cancers. Yet Husney, 52, of Olmsted Falls, found significant relief for what he'd been told might be a permanent condition -- through acupuncture.
After just a few acupuncture treatments, some of Husney's salivary function began to return, and his jaw started moving more easily.
"I'm very blessed -- my eating is gradually returning to what is close to normal," he said in a recent interview. "I ate my first apple today, without having to have a glass of water to wash down every small bite."
Patients get acupuncture for a variety of medical reasons. Some, like Husney, are current or former oncology patients; others might be suffering from severe menopausal symptoms. Some have post-traumatic stress disorder, anxiety, depression or joint pain.
A number suffer from xerostomia -- dry mouth, the condition that Husney has -- after being treated for thyroid conditions or cancer.
But acupuncture treatments cost $100 per session -- and Husney was having one or two a week. Medical insurance rarely covers acupuncture treatment, so patients pay out of pocket. For example, Medical Mutual of Ohio covers acupuncture only if a company has 50 or more insured employees and the employer wants it covered, said a company spokesman. It doesn't cover acupuncture in its individual policies.
Jamie Starkey, the lead acupuncture therapist at the Cleveland Clinic's Center for Integrative Medicine in Lyndhurst, has been working with Husney since last summer.
She was bothered that he and other patients might not be able to afford a treatment that could improve their quality of life.
"It made me sick to my stomach that this treatment could be cost-prohibitive to patients whom it could help," Starkey said.
She had an idea, though. She recalled that when she studied acupuncture and traditional Chinese medicine in Beijing, Chinese patients almost always got their acupuncture treatments in a group setting. Because of that, one acupuncture center there might treat 200 to 250 patients a day.
To her, the idea of shared appointments made sense: Because once the ultrafine needles are placed into the skin, there's a long period where the patient just rests -- perhaps 45 minutes -- with occasional check-ins by the therapist.
In fact, it's part of a new trend in this country known as Community Style Acupuncture (CSA) or sometimes community acupuncture.
But first, said Starkey, "I needed to make sure I could create a program where I could see a volume of people without compromising the outcome of their treatments."
So Starkey started the six-week pilot project in mid-October, using the employee meditation room at the Lyndhurst campus of the Clinic's Center for Integrative Medicine. She had the support of two allies: Dr. Michael Roizen, the clinic's chief wellness officer; and Dr. Tanya Edwards, medical director for the center. "It took a lot of planning and research, and we wanted to make sure we could pull it off," Starkey said.
So, for the pilot project, she and staffers placed 10 recliners in a darkened room that had been used for employee meditation. They angled the chairs in such a way that patients couldn't see each other. They did not believe additional separation was necessary as acupuncture patients don't have to undress -- they just roll up their sleeves or pants legs, or maybe expose a part of their belly.
It is important to Starkey, however, that she sees a patient one-on-one for the first appointment. "I want to be able to communicate with them about what they need, and what they expect as far as outcomes," she said. She also explains how acupuncture might work to improve their condition.
Also, Starkey said, some patients might have conditions that require needles in their backs or necks, so they have to lie facedown on a table. In that case, shared appointments might not be appropriate.
Based on patient outcomes after six weeks -- there were between two and 13 patients at each of the shared appointments during the pilot -- the clinic deemed it a success, and Starkey began offering the shared appointments one afternoon each week.
After an initial one-on-one visit, a patient can book a shared appointment, which costs $40 instead of $100. He or she enters the room, chooses a chair and prepares for the treatment. Soothing music plays quietly as Starkey and the patient speak to each other briefly, in quiet tones. She inserts the needles.
"Some people have told me they feel like they're in group meditation," Starkey said. Some relax or doze off.
Husney described it this way: "The lights are down, there's a little music, and it puts you in a meditative state. I feel like I'm alone, but then when I'm finished, I look around and the room is filled up."
At the end of an appointment, Starkey checks in with each patient.
Some don't respond to acupuncture, said Starkey, and she advises them to follow up with their doctors if they don't seem to be progressing.
Husney, who owns and operates a landscape design firm with his wife, still has some neck and jaw stiffness and dry-mouth symptoms, but said that all have measurably improved.
Being able to partake in shared appointments has been a huge financial relief, he said -- sometimes he goes once a week, sometimes less often.
After being in a cancer support group, "I was open to just about anything that might help me recover and improve some of the restrictions I have post-treatment. Jamie was pretty confident that my condition could be helped through acupuncture.
"And she was right."

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