The Chinese Herb Strategy at the Cleveland Clinic: Insights from Jamie Starkey, LAc, Program Manager

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.



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