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Your Comments: 4 Voices on Wellspace and Integrative Clinic Models PDF Print E-mail
Written by John Weeks   

Your Comments: 4 Voices on Wellspace and Integrative Clinic Models

Summary:  The recent Integrator article on the ultimate demise of Wellspace, a pioneering, venture capital-backed integrative clinic venture ("Wellspace/SickSpace: Reflections on a Pioneering Integrative Clinic Gone Down for the Count," November 27, 2007) provoked responses from former integrative clinic leader Michael Shor, MPH, former client Niels Bodecker, recent acupuncture school graduate Jessy Woodson and Mary Lawlor, CPM, the president of the National Association of Certified Professional Midwives. Lawlor's reflects on the economic and cultural parallels that the integrative clinic movement has with the birth center movement.
Are integrative clinics simply not meant to be venture capital funded? Should the ultimate owner-directors of Wellspace be thrown in prison? Can CAM graduates pay off their debts if we cannot prove solid business models? Do surveys say midwifery centers are turning enough profit to to roll-out a chain nationwide? All this, and more, in these comments to the Integrator article from November 27, 2007, "Wellspace/SickSpace: Reflections on a Pioneering Integrative Clinic Gone Down for the Count."

integrative clinics, Marino Centers
Michael Shor, MPH
1.   Michael Shor, MPH on the Wellspace and Marino models

Michael Shor, MPH was an integrative clinic pioneer. He founded an all-complementary practitioner center which became a part of the Marino Centers for Progressive Health, for which Shor subsequently served in an executive capacity. Marino began as all complementary, later adding integrative medical doctors. Marino is thriving, according to the latest report.
"Nothing like revisiting history to remind one of lessons learned and lessons lost.

"Having gone to the sidelines on CAM, but remaining actively engaged in the cost efficient delivery of high quality care (which by the way, we have successfully demonstrated is not mutually exclusive), it might be more interesting for you to compare the rise and fall of Wellspace with the experience of the Marino Center. Both required substantial seed funding. One has built a model which does integrate allopathic and complementary practice...and the other opted for parallel universe.

"Bottom line is that Massage Envy may have built a successful business model. My guess is the jury is really still out. My very serious question would be, does operating in the parallel universe offer the greatest clinical contribution or does integration make the greatest contribution. I keep my opinions, admit that I really don't know the answer, but would look forward to hearing from anyone that does.

"And just maybe at the end of the day, providing excellent care to those in need is just not meant to be a venture deal."

Michael Shor, MPH
Boston, Massachusetts

acupuncture student, student loans
Jessy Woodson, in orange, with acupuncture school classmates
2.   Jessy Woodson: the importance of solid business models amidst student loans

Jesse Woodson is a recent graduate of an acupuncture and oriental medicine program.
"I don't remember how I fell upon your blog, but I'm sure glad I did. As a recent graduate of Acupuncture school, I was very intrigued by the Wellspace & Massage Envy story you wrote. I'm not even thinking about corporate, franchise, or business models as I'm still struggling with licensure, but, I am an advocate for health & choice, & change.

"Just wanted to say THANKS FOR THE HEADS UP as to what's going on in the field, especially because we students were warned that we had a long row to hoe as far as acceptance in the we struggle to find ways to pay the onerous student loans!"

Thanks again,
Jessy Woodson

3.    Former Wellspace client: "new owners ruined the great energy ... "

In the original article on Wellspace I shared some comments from former staff members and clients. Another of these clients, Niels Bodecker, saw the article and wrote two responses.
"As a former client of Wellspace I am not surprised by it's demise. The new owners were a bunch of arrogant hot shots who ran rough shod over clients and employees. They ruined the great energy of a place of healing with their Harvard know it all attitudes. I for one knew that their negative energy would bring failure to the venture. I am truly sorry for all the pain they have inflicted on the investors and unsuspecting clients. I hope they go to prison and that they are ruined financially.
I contacted him with a note that i planned to publish it, and asked if he had more to say.
"I was a client. I had been going to Wellspace for a couple of years before [the new owners] took over; the previous owner and the practitioners who worked there put their hearts into creating that place. Within the first week I could feel the tension in the place and I almost immediately had problems with their so called billing system. Claims were not getting processed and even though I was actually ahead in my payments they claimed I owed them money. I had to produce my bank statements to show them the debit charges. In other words I was doing their job for them. Reputable business people don't make those kinds of mistakes. The whole billing system was fishy. The IRS should audit all of their financial doings."

Niels Bodecker
Boston, Masssachusetts

midwivery, integrative clinics, policy, NACPM, certified professional midwifery, birth centers
Mary Lawlor, CPM, with client
4.    Midwifery leader Lawlor: Birth centers as parallel structure to an integrative center

One of my particular passions in the discussion of healthcare change is how important I believe the experience of a natural birth process can be to inlaying an appropriate relationship to natural processes, but how little attention it gets. (See my related article:
"Father's Day: Reflections on My Firstborn's Homebirth as Alignment with What's Needed in Healthcare Reform," June 17, 2007.) Here Mary Lawlor, CPM, the president of the National Association of Certified Professional Midwives reflects on the similar place in the culture integrative clinics may have with birth centers.
"We met at a lunch with Jo Anne Myers-Ciecko in Seattle some months ago.  I am the president of the National Association of Certified Midwives (NACPM).  I have a 26-year homebirth practice and I am currently opening a birth center. 

"Midwifery can be considered a CAM profession, but very importantly, we also are primary maternity care providers. I am deeply interested in the development of effective models of distributing all types of health care, including, of course, midwifery care. That is my goal in opening a birth center and my goal of eventually offering support to as many others as possible to open birth centers.  In opening my birth center, I am focusing on developing a replicable approach. I thought of the experience of birth centers nationally as I read your article on Wellspace.

"The experience of Wellspace points out several flaws in their approach, as well reinforcing our awareness of well-known problems with our current health care system. 
 "If we look to high profit-
seeking sources to fund
distribution of complementary
health care, CAM is as
doomed as our current
health care system."

- Mary Lawlor, CPM


"If we look to high profit-seeking sources to fund distribution of complementary health care, CAM is as doomed as our current health care system.  Not only will it not work, but it will keep the access to CAM extremely limited, to the detriment of both consumers and providers.  Profit-making corporate funding cannot be the answer to the distribution to CAM, as private profit-seeking insurance reimbursement companies cannot continue to be the sole access to mainstream health care. 

"The statement from your article [is the key]: 'There was money to pay people to provide the services and cover basic overhead. As a healthcare operation, Wellspace was functional, economically.'  Any health care delivery system, CAM or mainstream, should provide access to consumers and a living for providers.  If we think of health care as a right of our citizens, then it cannot also be a typical source of wealth for investors.  National surveys continue to show that birth centers, for example, can pay providers and overhead, but are not able to provide a high return to investors.  However, I believe that provider-owned small community-based facilities can also pay back reasonable start-up costs and these models must be developed and implemented broadly.  Wellspace's goal of developing a relicable distribution model was a laudable one.   

"What I find very interesting in the Wellspace experiment, is the important idea of making CAM visible to health care consumers by housing it in establishments that look familiar enough to them that they can see themselves as customers. Midwifery care that is time-intensive, personal, effective and very satisfying to consumers
"We do need to continue
to think about how to
place CAM services in
settings that will make
them visible, and therefore
available, to consumers."

- Lawlor

can be provided through home birth.  However, the vast majority of women will never see themselves as homebirth customers. Birth centers show that women do want this type of care and that they will seek it out if it is housed in a facility. We do need to continue to think about how to place CAM services in settings that will make them visible, and therefore available, to consumers.

"And, of course, as CAM providers we need to participate in the current health care reform discussions and current state and federal reform proposals.  CAM providers must have a role in the development of whatever health care system eventually emerges.  CAM providers offer effective, cost-effective care and consumers must have ready access to this care.  NACPM is working hard to include Certified Professional Midwives (CPMs) in health care reform forums for these reasons.

"Thank you for your work."

Mary Lawlor, CPM, LM President
National Association of Certified Professional Midwives 

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