The American College of Traditional Chinese Medicine (ACTCM), based in San Francisco, has designed and launched an outstanding health care model in traditional Chinese medicine (TCM). This model utilizes TCM as a primary and secondary treatment modality delivered in a range of community-based clinics and established health care facilities throughout San Francisco. ACTCM's health care model provides a vanguard approach to integrating TCM into today's health care system that other communities can utilize.
Founded in 1980, ACTCM is a higher education institution dedicated to the advancement of traditional Chinese medicine. The school has designed a master of science curriculum that enables students to work side-by-side with experienced practitioners who are also faculty members. The college has established six clinical treatment sites throughout the city, in addition to its teaching clinic on campus.
Presently, ACTCM provides three treatment directions for the San Francisco community: 1) HIV/AIDS treatment delivered at four centers throughout the city; 2) Stroke recovery and rehabilitation provided to patients at California Pacific Medical Center; and 3) A collaboration with St. James Infirmary, an agency providing health care to people involved in (or transitioning out of) the sex trade. In addition, ACTCM plans to soon provide treatment to women living with breast cancer.
ACTCM's community-based health care model reaches Latino, African American, Asian and Anglo-American populations, as well as people of all sexual orientations and socioeconomic income levels. Community clinics are based in hospital settings, social service agencies and neighborhood health centers reaching insured and uninsured populations. Through ACTCM's teaching clinic and its satellite health centers, a model has been effectively established that delivers TCM in both mainstream and alternative health care settings.
ACTCM's treatment services include acupuncture; Chinese herbal medicine; nutritional counseling; tuina (massage therapy); and qi gong (gentle therapeutic exercise). At each clinic site, ACTCM has established a networking system to refer patients to other types of Western and Eastern health care practitioners and alternative therapies. Every person receives a treatment tailored to his or her individual physical, emotional and mental needs, beyond Western medicine's disease-oriented diagnosis and treatment model.
The results of ACTCM's community health care model have been outstanding. Over 50 treatments per month are provided to stroke patients at the California Pacific Medical Center; more than 350 monthly treatments are provided at several sites to low-income people living with HIV; and 40 treatments per month are provided at the St. James Infirmary to current and former sex workers. Over the past year, the number of patient visits has increased, and the results have been very promising. HIV/AIDS patients report being better able to comply with complex therapeutic regimes, and that acupuncture helps to offset numerous medication side-effects. Stroke patients report improved circulation and motor movements, as well as clear thinking.
Although ACTCM has been busy coordinating and implementing its model of health care, the college plans to implement a qualitative and quantitative assessment of its diverse treatment program. The program provides significant opportunities to track patient progress; hold one-on-one and group interviews; and monitor patients' conditions. Currently, ACTCM is examining and organizing an evaluation panel comprised of leading TCM practitioners, clinical researchers and health care administrators to coordinate the research design of an assessment and oversee its value.
ACTCM's work contributes to the momentum that TCM is gathering within the United States. Over the past 20 years, acupuncture has gained greater acceptance from America's mainstream medical institutions. TCM is receiving stronger support from state and national legislative bodies, and acupuncture is introduced at most leading medical schools, including Harvard University and Johns Hopkins University Medical Center. The National Institutes of Health has allocated more than $100 million dollars in grant support for rigorous complementary research projects this year alone. Two clinical trials have been funded that are studying the effectiveness of acupuncture in treating HIV-related disorders. The studies have entered phase II status, and data is being gathered and analyzed.
Treating HIV/AIDS
In 1992, ACTCM contracted with the AIDS Office of the San Francisco Department of Public Health to provide medical care to low-income people living with HIV or AIDS. Many HIV-positive clients look to TCM because it addresses the physical disease as well as its ramifications on a mental, emotional and spiritual level. The college's HIV/AIDS program is focused on supporting the "healthy functioning of the body" (fu zheng) and "eliminating pathogenic factors" (qu xie) associated with HIV infection. Acupuncture in particular has been effective in addressing numerous side-effects of anti-HIV medications such as nausea; vomiting; diarrhea; neuropathy; and insomnia. Acupuncture helps patients adhere to their complex HIV treatments and live with an improved sense of well-being.
Treating Sex Workers
ACTCM began working with St. James Infirmary this year. The infirmary is a street-level clinic run for and by former, current and transitioning sex workers. Fearing stigmatization or disrespect, sex workers are faced with numerous challenges in obtaining and receiving adequate health care. Often, their work is a shameful secret from their families and friends. Many are dealing with a history of sexual abuse; the trauma of domestic or work-related violence; or substance abuse. Some are hopeless. Others feel trapped in their occupation, but see no way out and are not aware of the resources that can help them. They often do not inform their health care practitioners about their profession, which may cause health care providers to overlook medical tests for communicable or sexually transmitted diseases. If they do convey their profession, physicians may only focus on STDs and HIV, and overlook other disorders or illnesses. Thus, sex workers are faced with a lack of complete care and often do not seek treatment in mainstream medical settings. ACTCM and St. James Infirmary together strive to provide a non-judgmental environment in which patients can be honest and confident. The provision of health education and treatment to this population results in a public health benefit for the larger community.
Treating Stroke Patients
ACTCM is taking part in a study with California Pacific Medical Center (CPMC) to determine the efficacy of acupuncture in treating patients who have suffered from stroke. Three ACTCM staff members currently work three times a week at CPMC's Rehabilitation Center. The patients are admitted based on a referral from a medical doctor. Starting this summer, students have gone into the center with licensed practitioners, incorporating acupuncture for stroke into their regular learning. Thus far, acupuncture has shown promising results in restoring movement and circulation. Specifically, practitioners are conducting the study to determine whether acupuncture can stimulate sensory-motor pathways to restore normal, voluntary movements and functions in stroke patients.
ACTCM sets forth a model to be followed as TCM makes the transition into being recognized on a national level as a viable and effective primary and secondary care health modality. Through the provision of valuable TCM services on a community-based level, underserved populations can access a full continuum of Eastern and Western therapeutic modalities, and students of TCM may improve their overall efficiency through exposure to a diverse clientele.
Janice Gorton
Mindy Mortlock
San Francisco, California
Editor's note: For further information, please contact Kaylah Cheryl Sterling, dean of ACTCM's clinic, at kaylahcherylsterling@actcm.edu.
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