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Chinese Herb Strategy at the Cleveland Clinic: Insights from Jamie Starkey, LAc, Program Director |
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Written by John Weeks
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The Chinese Herb Strategy at
the Cleveland Clinic: Insights from Jamie Starkey, LAc, Program Manager
.jpg) Pioneering Chinese herb clinic
I recently spoke with Jamie
Starkey, LAc on the widely reported Chinese herb program she had the lead
in founding at the Cleveland Clinic. How did the team get this unique
program through? While scores of hospitals and health systems have
acupuncturists on staff, this appears to still be the singular Chinese herb
program housed in a large medical delivery organization in the United States.
The program is located in an outpatient facility. It does not serve inpatients.
Starkey spoke to the powerful support of the founding director of the Clinic's
integrative medicine center, Tanya
Edwards, MD, now deceased. She then reflected on her own longevity there.
The half-Korean science major has intentionally built relationships at
Cleveland Clinic since 1997 in multiple roles, including quality assurance on
clinical research projects under skills gained through her biology degree. She believes
that her comfort in Western sciences and in traditional Chinese medicine (TCM)
has helped, generally, in her development of the entire TCM program there.
 Starkey: guided program into being
Then Starkey spoke to her strategy with the herbal products themselves. Her sense
of the Clinic's patients was that they would be more likely to fulfill on their
prescriptions if the herbs were delivered familiarly and time-efficiently. She
admits to extrapolating from her own challenges in complying with the elaborate
ritual of preparation of teas under traditional prescribing: "I was
non-compliant as a patient." She knew she was looking for delivery via
capsules ideally, or powders. Knowing the Cleveland Clinic culture, she assumed
that more standardized forms than taking the whole raw herbs and concocting
medicines would be better. She also decided early that it would be a
non-starter to promote placement of a Chinese medicinal formulary onsite at the
outpatient integrative medicine center. She needed another form of delivery.
Starkey began researching and speaking to possible corporate partners. The
bi-coastal Crane Herb Company was
suggested by a colleague. She recalls her initial connection to Crane founder
and CEO Bill Egloff. She laughed: "When Bill called me back, he started to
interview me. He wanted to know all about what we were doing. He was interested
in our mission. He cared about our intention and plans. The other companies did
not ask about this. It was unforgettable."
 Thoroughly vetted herb supplier
Crane, she discovered, offered a method of fulfillment that met her vision. The
Clinic's herbalists could diagnose and prescribe. The orders were then filed
with Crane for a "custom blended formula" that Crane would
individually concoct and package. Crane used herbal granules from a Taiwanese company that was chosen "due to their superior quality," said Starkey. The look of the product mattered: "The Crane
labeling is as if taking a true pharma drug. The labeling is in accordance with FDA guidelines." Crane ships out for a
two-day turnaround. Starkey noted that because "we don't don't see many acute conditions," the short wait is
not problematic.
Starkey underscored that in her strategy, "identifying the actual herbal product was a major concern for not only myself but physicians and pharmacists here at the clinic." The core concern was with quality: "I needed to make sure the herbal product was not contaminated with heavy metals, pesticides, and other pharma drugs." She added that accuracy of species was an additional quality concern. The decision to source from the Taiwanese company, KPC, followed discussion "with everyone on the team." She adds that Crane "uses KPC granules for all their products."
 Presentation on Cleveland Clinic's programs
Starkey said that the Chinese herbal clinic has thus far served over 600
patients in its first 18 months. She will be speaking on this topic on February
27, 2016 at the Integrative Healthcare
Symposium as a part of a panel on the robust integrative activity at
Cleveland Clinic. The other participants will be Mark Hyman, MD and Patrick
Hanaway, MD, each with the Clinic's Center
for Functional Medicine program, and Melissa Young, MD, director of the
Cleveland Clinic's separately-located
Tanya Edwards Center for Integrative Medicine, where the Chinese herbal
program is housed.
Comment: I had the opportunity to develop this IHS panel, for which I
will serve as moderator and set-up guy. I look forward to hearing what they
have to say. Meantime, one wonders what is lost in the translation of Chinese
herbal concoction to Crane's capsuled formulations. Integration is a marriage,
and any survivor in the latter institution will know that compromise, and
willingness to change behaviors, are elemental to success. Starkey's strategy
brought Chinese herbs and the Cleveland Clinic to the altar. Eighteen months
in, something seems to be working! Kudos to Starkey and the team.
Side note: It does not hurt that Starkey appears to be a person of significant
personal power. Her responsibilities with Cleveland Clinic, for instance,
include effectively being on call as the acupuncturist for the Cleveland
Indians baseball team, no job for a shrinking violet. Alignment of interest
note: Crane Herb Company has been supportive of an organization I formerly
served as executive director, the Academic Consortium for Complementary and
Alternative Health Care.
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