How integrative practitioners are making healthcare more financially accessible

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By Brittany Vargas

The cost of integrative medical treatment is beyond many people’s reach, according to a 2016 study in Global Advances in Health and Medicine but practitioners across the United States are trying to make services more affordable.

“My vision was to bring medicine back to the people, because herbalism is the people’s medicine and always has been,” said Leslie Chaison, herbalist, founder, and program co-director at The People’s Medicine Project in Greenfield, Massachusetts.

Powered by qualified, experienced volunteers, they provide a variety of healing services for free including acupuncture, homeopathy, craniosacral therapy, herbal consults, massage therapy, and reiki. They also help communities become more self-reliant via herbal education and low-cost herbs.

The health justice organization primarily serves communities in urban centers plus those in addiction recovery and farm workers with minimal resources. Cost bars their clients from getting treatment elsewhere, as does a lack of culturally inclusive, compassionate care from allopathic doctors, according to Nathalie Fischer-Rodríguez, herbalist, and program co-director at The People’s Medicine Project.

“We see folks not accessing healthcare because they’ve been treated poorly by the medical community,” she said.

Not everyone who seeks affordable treatment comes from a marginalized community.

“People think, ‘Oh, you’re treating unhoused people.’ Actually, we’re too expensive for unhoused people. But we do have a really diverse patient population as far as race, gender, and age go,” said Melissa Craven, MS, LaC, licensed acupuncturist, and co-founder of Circle Community Acupuncture in San Francisco.

Circle offers sliding scale fees of $30 to $65, up from $15 to $40 before the COVID-19 pandemic.

Patients are seen four at a time (down from six pre-pandemic) in the same calm, quiet room. Each patient rests in a soft reclining armchair and is treated directly there.

Craven explained that by staggering appointment times and treating multiple people in one room, she’s able to keep the fees low. The communal room does limit what can be done in a session, though.

Universal Family Clinic in Los Angeles provides sliding scale services in East Asian herbal medicine, functional blood chemistry analysis, acupuncture, Chinese herbalism, bodywork (including tui na, Chinese medical massage), fire cupping, moxibustion, and nutrition. Practitioners treat adults and children and operate on a sliding scale of $50 to $80 per treatment, plus a $40 low-income rate and a $90 high-income rate.

The owners and directors of the clinic, Michael Niss, MS, LaC, and his wife, Brooke Niss, MS, LaC, are passionate about providing an alternative to profit-minded medical care. In fact, Michael Niss said he pursued East Asian herbal medicine instead of other medical modalities because he could do the most good with it.

“[My wife and I] both found acupuncture because it allows you to provide care for a very wide variety of health concerns for a very affordable cost,” he explained.

Making a living while providing affordable care

The People’s Medicine Project — which doesn’t have a permanent location and thus has a lower operating cost — is a grassroots organization funded by grants and individual donations. But it hasn’t been easy to stay afloat.

“It’s really hard to fund the work. I’ve found it to be a constant struggle over the years,” said Chaison.

Craven also cites finances as one of her biggest challenges at Circle, which is a registered nonprofit with a location in downtown San Francisco. Besides keeping costs low, she also uses donations and grants to keep it running but says it’s tough finding grants for acupuncture clinics.

“I probably don’t make a living wage,” she said. “I have a husband, and we have a rent-controlled apartment. That’s how I can do the work I do.”

Her staff members are generally in a similar position, she said, of not needing to make a lot of money. So when someone leaves, filling the vacancy is tough.

Niss and his wife were able to create a business model that allows them to keep costs affordable but also pay their staff well.

“We thought maybe if you could work the numbers in such a way that because you’re providing a lower cost care, people can access the care more frequently, and because they can access the care more frequently, you get better results in their treatment. And by then getting results in their treatment, you keep your schedule full,” he said.

The rates at Universal Family Clinic — while higher than those at Circle Community Acupuncture and People’s Medicine Project — are still comparatively low, according to a 2019 study in the Journal of Integrative Medicine.  

He said their goal is to provide treatment “on a sliding scale that allows patients to choose their own price without scrutiny to their income. So that even if they are a high-income earner, but have many children, deaths, or other circumstances that are outside of their control, they can get access to care that is incredibly top notch.”

Making a positive impact with affordable care

No matter the costs, each clinic is providing quality treatment that has clear benefits, including reducing chronic pain, treating fertility issues, managing pregnancy, reducing addictive impulses, providing mental health support, and reducing stress.

Plus, practitioners can provide these benefits without driving their patients into debt — Niss recalled helping a woman in her mid-40s get pregnant with treatments that cost a total of less than $500.

Community clinics also help mitigate the negative health effects of isolation, including increased mortality, which is on par with alcohol consumption and obesity, according to a 2018 paper in Scientific Reports.

“We have a lot of people that come to us going through transition, saying, ‘I just lost my job,’ ‘I’m going through divorce,’ or ‘I’m new to the city.’ People find us in those times and we help them navigate it,” explained Craven.

Chaison recalled a man who’d been getting treatment for his addiction to prescription medication. When he dropped off for a few months but felt safe enough to come back, it confirmed for her that the benefits of their service were beyond simple reduction in symptoms.

“He was like, ‘Are you guys disappointed in me?’ I feel touched telling this story because we realized that success looks really different from, ‘I’m off benzodiazepines now. This was a success. Check.’” she said. “We don’t see this as a failure. He had a place to come back to and be supported and accepted wherever he was at.”

“Friends come together; families come together; people have little ‘acu-dates.’ It’s a way for people to spend time together and take care of themselves,” said Craven.