By Kristen Porter, MS, MAc, LAc and Beth Sommers, PhD, MPH, LAc
The concept of Kang Wen, or "defeat the epidemic," has a long history in the evolution of Chinese medicine. Even in the 12th and 13th centuries, medical records indicate that wars, famines and various types of epidemics affected health and disease, exerting influence by actually altering the nature of illness.1 Zhang Yuansu, a physician of the 12th century, described the changing clinical landscape as follows: "Ancient and modern times follow different patterns of seasonal qi; old prescriptions are less effective on today's disorders." He encouraged his contemporaries to develop their understanding of pathogenic forces in order to successfully treat their patients.
Although the prevalent diseases of that time included bubonic plague and smallpox, the lessons learned remain relevant today.
Kang Wen Clinic, located in Seattle, carries on this tradition of healing. Founded in 1987 by acupuncturists Tai Lahans and Tori St. Clair, the clinic pioneered in offering care to people living with HIV/AIDS. Kang Wen's mission has historically been to offer affordable and accessible services that improve the health and quality of life for its clients.2 After initially incorporating and offering acupuncture and Oriental medicine services, Kang Wen became a 501(c)3 nonprofit organization in 1991. The clinic's mission expanded in 2000 to include offering treatment to individuals with other serious chronic illnesses such as cancer.
The scope of clinical services offered has continuously evolved over Kang Wen's 19-year history. These currently include Chinese, Japanese and Korean acupuncture styles; cupping and moxibustion; herbal medicine; tui na; acupressure; qi gong; tai qi; and therapeutic nutrition. Naturopathic nutritional consultations are also available. Kang Wen's staff includes several acupuncturists and support staff, an active board of directors, and a client advocacy group that helps shape the mission by providing feedback for improving services.
Jung Kim, interim director and acupuncture researcher, said, "My passion is the integration of OM into the community. The idea of creating community between Kang Wen and the conventional provider and public is what keeps me motivated."
Clients at Kang Wen who are diagnosed with HIV/AIDS are eligible for low-cost care through the federal Ryan White Care Act. Services are priced at approximately 20 percent of the cost of similar care at private clinics. By working as a team with the clients' other medical providers, Kang Wen fosters collegial relationships with conventional health care practitioners.
In their cancer treatment program, Kang Wen offers specialized care for individuals seeking an integrated approach to dealing with their illness. Treatments include both acupuncture and herbal medicine, similar to cancer treatments offered in China, South Korea and parts of Europe. "Educating patients is a central keystone of the program with an emphasis on continuity of care," states Tai Lahans, MEd, MTCM, LAc.3
A majority of their clients live with chronic illness and have incomes near the federal poverty level. Because public assistance does not reimburse for CAM services, Kang Wen seeks to provide affordable treatments and has developed a fee schedule based on its clients' monthly income; discounts are offered on herbal and nutritional supplements. Although the clinic initially relied on funding from grants, funding streams have been diversified in the past few years to include both public and private sources, as well as a fee-for-service model. Charging for services was a recent change that was a marked departure from years of free service. Clinic representatives informed us that their clients were "willing to pay for services because they feel they are contributing to their wellness rather than receiving Ôhandouts' from the previous model."
In order to further Kang Wen's mission, ongoing efforts are being made to integrate services into settings that promote public health and increased access to care. Kang Wen collaborates with Bastyr University and the Seattle Institute of Oriental Medicine, as well as other local institutions and nonprofit organizations. Clinic representatives say that the most encouraging aspect of developing these partnerships is the positive receptivity Kang Wen has received, especially from conventional health care providers. Identifying and focusing on finding common ground for achieving patient wellness has been part of the clinic's successful strategy to develop favorable working relationships.
Kang Wen's first residency training in oncology recently began in affiliation with the Seattle Institute of Oriental Medicine. The residency involves both didactic and clinical sessions, and includes visits to conventional medical institutions to observe surgeries and other interventions.3 This one-year postgraduate residency is available for practitioners who have at least five years of experience in Oriental medical practice, and has been approved for continuing education credit by the National Certification Commission of Acupuncture and Oriental Medicine (NCCAOM).
Kang Wen's commitment to public health reflects itself in aspects of education, advocacy, access promotion, community partnerships and public accountability through ongoing evaluation of services. Terry Courtney, dean of the School of Acupuncture and Oriental Medicine at Bastyr University and a notable public health advocate, offered her assessment of Kang Wen's activities as follows: "The mission of Kang Wen Clinic is to provide CAM clinical, research and advocacy services to people struggling with chronic and often debilitating illness. Since Kang Wen's inception in 1987, the clinic has moved its mission forward despite challenges with funding, physical space and staffing. The standard of excellence that Kang Wen strives for is a model for all CAM public health initiatives."
Defeating the epidemic of disease and social ills remains as germane today as it was during the Song, Yuan or Ming periods, when access to medicines and health care was provided by local officials intent on resolving public health crises.4 Kang Wen's practices are rooted in the centuries-old traditions of Chinese medicine, while simultaneously envisioning creative and innovative approaches to address 21st-century disharmonies. The clinic's successes, especially its ability to withstand challenges of funding, can be an inspiration to all of us who see wellness as a right, not a privilege.
Furth C. A Flourishing Yin: Gender in China's Medical History, 960 - 1665. University of Chicago Press, 1999, pp. 134-137.