1. Integrative Medicine for the Underserved Practicing as an Herbalist in a Integrative Free Clinic

3. The Ithaca Free Clinic is a program of the Ithaca Health Alliance which was founded in 1997. The IHA saved for 9 years to open a free clinic which opened its doors in January 2006.The Ithaca Free Clinic is a program of the Ithaca Health Alliance which was founded in 1997. The IHA saved for 9 years to open a free clinic which opened its doors in January 2006. The IHA is community driven organization not affiliated with any sponsors. This gives more discretion for the board, but makes it more difficult to fund.The IHA is community driven organization not affiliated with any sponsors. This gives more discretion for the board, but makes it more difficult to fund. 3 primary objectives are; promote accessible primary care, support people’s financial health as related to health care and help our local community make informed health choices.3 primary objectives are; promote accessible primary care, support people’s financial health as related to health care and help our local community make informed health choices. Primary core medical modalities are conventional medicine, herbal medicine and acupuncture, Primary therapeutic modalities are massage and chiropractic.Primary core medical modalities are conventional medicine, herbal medicine and acupuncture, Primary therapeutic modalities are massage and chiropractic.

5. Ithaca Free Clinic Ithaca Free Clinic

6. Ithaca Free Clinic Goals 1.Free health services for those in need. 2.Offering patients health care choices. 3.Outreach and education. 4.Promote an integrative model of health care. 5.Help with patient’s with understanding their personal control with their health processes.

7. Outreach and Education

8. Challenges facing the Free Clinic Herbalist 1.Financial considerations 2.Acquiring donations 3.Equipment expenses 4.Working with other types of practitioners 5.Storing medicines 6.Preparing medicine(s) at the clinic 7.Patient compliance with medicines and holistic approaches 8.Working with patients new to herbalists and herbal medicine

9. Preparing Medicines for the Patient at the Free Clinic 1.It can save the patient money and time if the medicines are prepared for them during their visit. 2.Another advantage is you can give clear and visual directions with medicines in hand. 3.Will you be preparing the medicines in the consultation room or elsewhere? 4.Will it be part of the consultation time, or afterwards? 5.Will you be preparing the medicines or will others? 6.Medicine formulation and preparation can be complicated and need to be figured out early on. Will you be preparing in parts? How will the medicines be organized?

10. Preparing Herbal Medicines at the Free Clinic

11. Rewards of being a Free Clinic Herbalist 1.Reaching patients who could otherwise not afford herbal medicines or seeing an herbalist. 2.Helping make herbal medicine accessible and affordable. 3.Helping people understand the value of herbal medicine (as well as overhyped marketing). 4.Working with other practitioners, both conventional and holistic. 5.Helping herbal medicine move out into a wider demographic. 6.Helping people with their health issues.

12. Planning and Setting Up Considerations 1. 1.Who will be involved in the early stages of planning the clinic? 2. 2.What types of people are you looking to work with for organizing, planning and practicing? 3. 3.How will you structure your meetings and committees? 4. 4.How much time do you have to commit to this project? 5. 5.What finances do you have available? 6. 6.As there is no licensing for western clinical herbalists in the US this should be addressed, as some people might find this an uncomfortable situation.

13. Free Clinic Herbalist Equipment 1. 1.Calculator 2. 2.Demonstration equipment-tea press 3. 3.Dispensing equipment-bottles and bags 4. 4.Labeling equipment-printer, software, labels. 5. 5.Laptop-for notes and to search for information 6. 6.Measuring equipment-scales and measuring cups 7. 7.Notebook/paper-for practitioner and patients 8. 8.Shelves 9. 9.Storage areas on-site and off-site

14. The Free Clinic Herbalist Room

15. Free Clinic Herbalist Equipment

17. Skills for the Free Clinic Herbalist 1. 1.Diagnosis and Assessment 2. 2.Counseling 3. 3.Formulating 4. 4.Physiology and pathophysiology 5. 5.Specific plants 6. 6.Treatment strategies 7. 7.Understanding the medicines, diagnosis and treatment of other modalities.

18. 1. 1.Herbal medicines can take up a lot of room (think large bags of dried herbs versus pills). 2. 2.If you are working at a clinic, where will you be storing and distributing your medicines? 3. 3.Will you keep all or part of the herbal medicines at the clinic or will some of the medicines be kept off-site such as at a home? 4. 4.Will you be preparing the medicines on-site for the patients, or will they be made elsewhere? 5. 5.If they are made off-site, how will the patients know where and how to pick them up?

19. 1. 1.Understanding basics of other health care practices is helpful in comprehending the diagnosis and treatment of other modalities and in making referrals. 2. 2.Let other practitioners know the basics of herbal medicine and how you practice. 3. 3.Practitioners may be sharing information and files with each other, a consideration when writing up your patient visits. 4. 4.It may be helpful to discuss possible interactions of herbal medicine with drugs and treatment of with practitioners of other modalities.

20. Patient Compliance for the Free Clinic Herbalist 1. 1.Consider how herbal medicines may be different than a patient’s previous medicines in taste, preparation forms, directions, and dosage. 2. 2.Not overwhelming with too many medicines 3. 3.The different preparations of herbal medicine can be difficult to prepare and take. These include, teas, tinctures, compresses, oils, salves, powders and capsules. 4. 4.Factor in frequency and dosage of each medicine and see if this works for an individual within their temperament and/or schedule. 5. 5.Can different medicines be taken at the same time?

21. Acquiring Donations 1. 1.Donations are an important consideration working as a free clinic herbalist if you are preparing and distributing free herbal medicines. 2. 2.How and who will search for the donations? 3. 3.What type of donations are you looking for; medicines, equipment, money or something else? 4. 4.Who will keep track and hold on to the donations? 5. 5.What resources do you have already to reach out for donations? 6. 6.How to contact organizations and individuals looking for donations. 7. 7.Will you be sharing medicines with other clinics? How will you arrange transport of the medicines amongst the clinics, (shipping can be very expensive)?

22. Common Health Conditions Seen by the Free Clinic Herbalist 1. 1.Cardiovascular disorders 2. 2.Chronic health conditions (i.e., Lyme disease, Chronic fatigue, Autoimmune) 3. 3.Conditions considered undiagnosable or untreatable 4. 4.General health check-up 5. 5.Gynecological disorders 6. 6.Idiosyncratic health disorders 7. 7.Insomnia 8. 8.Mental health (anxiety, depression, ‘stress’, cognition difficulties) 9. 9.Pain

23. Common Medicines used by the Free Clinic Herbalist Anemone Ashwagandha Astragalus Black cohosh Calamus Catnip Dandelion Echinacea Eyebright Ginger Ginkgo Goldenrod Hops Jamaican dogwood Kava kava Lemon balm Lemon verbena Licorice Lobelia Marshmallow Oregon grape Passionflower Redroot Reishi Rose Skullcap Tulsi Valerian Vitex Willow

24. Affordability and Accessibility Considerations 1. 1.If the patient is going to get their medicine outside of the clinic, are your recommendations obtainable and within their financial means? 2. 2.If they are getting medicines and treatment outside the clinic, what are the comparative costs of herbs versus conventional medicines? 3. 3.Does the patient have insurance and how will this affect your recommendations? 4. 4.If you offer free herbal medicines, how will the practitioner be able to afford the medicines given to patients? 5. 5.Will these medicines be given continually for free?

25. Patient Considerations for the Free Clinic Herbalist 1. 1.If a patient is new to holistic practice, it can be helpful to let them know why you are asking some of the questions that may not be commonly asked. 2. 2.Trust and confidentiality are cornerstones of practice. 3. 3.It is important to offer the best options for patient’s health, whether from one’s own skills or from another practitioner. It is more important to provide health services than promote an agenda. 4. 4.Key concepts when considering treatment; affordability and accessibility. 5. 5.Avoid assumptions.

26. 1. 1.There is a fine line between educating and over-informing. Watch, listen and ask to make sure your patient is getting the right amount of information for them to take in. 2. 2.Discuss why you are asking certain questions and making specific recommendations. 3. 3.Suggest resources such as internet sites you trust. 4. 4.Have brochures explaining aspects of herbal medicine. 5. 5.Explain dosages with each new patient. Use visual aids. This can be done for each new type of preparation. 6. 6.Be a bridge between conventional and holistic medicine for your patients. 7. 7.If they ask about their drugs, medical procedures or lab results it can be very helpful to have them explained by someone with an understanding of them. Educating Patients

27. 8. 8.When appropriate, explain how marketing often oversimplifies the actions of many herbal medicines. 9. 9.Consider word choices with your patients whether in educating them about their condition or why you are choosing certain herbal medicines and treatments. Is your language understandable? 10. 10.It can be helpful to show how to navigate the web and look for information or products online. 11. 11.For interested patients, let them know resources to research their illness and the medicines they will be taking.

28. Free Clinic Herbalist End Notes 1. 1.While not yet common, herbalists can integrate into existing free clinics or join with others to start new ones. 2. 2.Herbalists and herbal medicine have a lot to offer for an interested and opening up public. 3. 3.For interested patients, herbal medicines can be purchased, gathered and prepared by themselves. 4. 4.While it can be time consuming and financially expensive, it is very rewarding helping make herbal medicine accessible and affordable.

29. Questions?