Introduction by Vice Chancellor Steve Goldstein
In this installment of Bridging the Gap, we highlight how integrative health is expanding through the UCI Health Family Health Centers in Santa Ana and Anaheim. These Federally Qualified Health Centers (FQHCs) are community-based health care providers that deliver primary care to underserved populations.
Under the leadership of José Mayorga, MD, executive director and chief medical officer, the UCI Health Family Health Centers are ranked in the top 10% of FQHCs nationally as quality leaders. Our growth over the past year has been significant, welcoming over 2,000 new patients and managing 5,000 more clinical visits. This expansion showcases our commitment to enhance access to healthcare and address the needs of our diverse patient population.
Through an innovative partnership with the Susan Samueli Integrative Health Institute, UCI Health Family Health Centers implement whole-person care through their offerings of group medical visits, activities in the teaching kitchen, and integrative health treatments such as acupuncture and mindfulness. This integrative care helps patients gain access to information and resources to help prevent diseases and improve their overall health.
For patients coming to the FQHCs with chronic pain, we are seeing great success with acupuncture. A pillar of traditional Chinese medicine, it has become a key component of integrative healthcare. To meet an increasing demand, a significant number of acupuncture sessions were provided this year, which marked a 320% increase from last year’s offerings. In addition, integrative health visits, including acupuncture, mindfulness and group visits, were provided to 1,185 patients, a 70.5% increase from the last fiscal year.
I am delighted to see this demand for the discipline of integrative whole-person health and applaud our teams for expanding access across Orange County. This is another example of the synergy between our strategic priorities at UCI Health Affairs, uniting our commitments to Advancing Health Equity and to Innovating in Healthcare Service and Support for Lifelong Wellness. Embracing a One Health vision, our efforts are rooted in the alliance of health disciplines to drive scientific breakthroughs, educate a diverse healthcare workforce, and deliver whole-person, team-based, precision care equitably for all.
UC Irvine Brings Integrative Health Solutions to Federally Qualified Health Centers, Increasing Access to Acupuncture in Underserved Communities
Featuring Shaista Malik, MD, PhD, MPH, Richard Harris, PhD, Kim Hecht, DO & José Mayorga, MD
It is estimated that 21% of adults in the United States suffer from chronic pain. This condition, which is pain lasting three or more months, can be devastating, leading to a decreased quality of life, lost productivity and wages, and the worsening of other health conditions. Chronic pain has even been linked with depression, Alzheimer’s disease and related dementias, increased suicide risk, and substance use and misuse. When an increasing number of people are living with pain, it is critically important that they have access to therapies that can provide much needed relief – no matter their income, insurance status or ability to pay. According to a recent survey, 61% of people say affordability is one of the biggest barriers to care, and 40% say they have skipped or delayed healthcare in the last two years due to the fear of how much it would cost. To address the growing issue of chronic pain, it is vital to address both access and affordability.
That is why the Susan Samueli Integrative Health Institute is committed to increasing access to meaningful, evidence-informed integrative health treatments for underserved patients at the UCI Health Family Health Centers in Santa Ana and Anaheim, two Federally Qualified Health Centers (FQHCs).
For patients coming to the FQHCs with chronic pain, we are seeing great success with acupuncture. It is a pillar of traditional Chinese medicine and has become a key component of integrative healthcare. Acupuncture is a technique that involves stimulating specific points on the body to relieve pain and treat health conditions, usually by inserting small needles into the skin.
Richard Harris, PhD, Susan & Henry Samueli Endowed Chair in Integrative Health and School of Medicine professor, explains that the research behind acupuncture has been around for several decades now and “has grown exponentially in the current years.” He says there is a lot of basic scientific data that has investigated how acupuncture works with neurotransmitters, hormones, inflammation and the immune system.
“There is a lot of clinical data in humans that shows how acupuncture is effective if not efficacious for a lot of conditions,” he says. “In the U.S., it is used commonly for pain, and there is a lot of acupuncture data on its effectiveness for various pain conditions.”
Other conditions acupuncture has been shown to help, Harris says, include drug addiction, depression, anxiety, high blood pressure, cardiovascular disease, rheumatoid arthritis, menopause and menstruation.
Harris notes that the benefits seen from acupuncture alone or together with other treatments go beyond just a reduction in pain levels. These collateral benefits include improvements in sleep, GI function and mood, as well as reductions in stress, anxiety and fatigue.
Our own patient data supports this. In the past, our patients receiving acupuncture treatments have reported decreases in pain levels, anxiety levels, nausea levels and increase in relaxation levels. They have also reported improvements in sleep quality and the facilitation of functional gain when used with physical therapy.
What makes acupuncture even more valuable for these patients is that it is a non-pharmacological way of providing pain relief and other benefits. Kim Hecht, DO, medical director of inpatient and ambulatory services for the Samueli Institute, highlights the fact that chronic pain patients may already be navigating other health conditions or medications.
“They don’t need another pill to take,” she says. “If you can decrease the pharmacologic burden, improve quality of life by decreasing their pain, and do it in a way that is natural without side effects, it’s a win-win-win.”
Harris agrees, saying that the literature supports acupuncture as a “very safe” therapy. He calls attention to the “off-target effects” that medications can bring. For example, opioids work by blocking pain signals in the body, but they can come with devastating side effects such as death, because they have the potential of suppressing the body’s breathing function and nervous system.
“Ideally you were taking it to reduce pain, but it can kill you if you take too much of it,” Harris says. “One of the things that’s nice about acupuncture is that it doesn’t have many side effects.”
Because of minimal side effects, Harris says acupuncture is a good treatment for combining with conventional medicine and providing truly integrative care. “Chronic conditions often require a combination of therapies, not just a magic pill that stops all the issues. And acupuncture is good for that,” he says.
Considering this, we’re thrilled to see our acupuncture services growing rapidly at the FQHCs. In the 2022-2023 fiscal year, those locations saw a 320% increase in acupuncture sessions. Additionally, integrative health treatments (including acupuncture), were provided to 1,185 patients, a 70.5% increase from the previous fiscal year.
Growth in integrative health services is also being seen nationally. A recent study shows that 37% of adult pain patients used nontraditional medical care in 2022, a near doubling from 19% in 2002.
But a pertinent question may be why these services are growing at warp speed. It could help to look at the current state of the American healthcare system. According to a recent survey, more than 70% of people say they feel the system is not meeting their needs in some way. Reasons include feeling like providers are only focused on treating illness instead of offering preventative care and promoting wellness. It’s clear that patients do not just want medications for their problems; they want comprehensive care that can restore their wellbeing. Integrative medicine meets this critical need, offering care that looks at the whole person – not just separate organs or body systems – and considers multiple factors that promote either health or disease.
Looking specifically at the FQHCs where the Samueli Institute offers care, Jose Mayorga, MD, executive director and chief medical officer of the UCI Health Family Health Centers, says there are several reasons acupuncture services are growing. He says the patients who receive care there, who are predominantly Latino, tend to “seek various modalities to treat their medical ailments,” including integrative health therapies.
“Furthermore, the demand may have increased since many acupuncturists in Orange County, California, do not accept government/state insurance known as Medicaid (known as Medi-Cal in California) because of the poor reimbursement rate,” Mayorga adds. “In the FQHC model of care, we can offer these services.”
“Fundamentally, the FQHC’s mission is to provide access to care equitably to all; offering acupuncture makes sense and is the right thing to do,” Mayorga says. Essentially, when holistic pain relief can be found at an affordable cost, it makes sense to see an increased interest in integrative health treatments.
It’s clear that acupuncture is providing meaningful relief to patients who need it. Shaista Malik, MD, PhD, associate vice chancellor of integrative health and executive director of the Samueli Institute says, “When it comes to the future, we hope to bring more acupuncturists to the FQHCs to meet the growing need of the communities. This clinical expansion is in step with growing evidence that supports acupuncture as an effective therapy, including rigorous acupuncture research being done right here by UCI faculty in not only chronic pain conditions but also in those with cardiovascular disease and cancer.”
Harris, the co-president of the Society for Acupuncture Research, is also the co-principal investigator on a large NIH grant, the Topological Atlas and Repository for Acupoint Research (TARA) project. It will create an open-access, 3D database of all the acupoints on the body along with the published research that supports the stimulation of those points. TARA has the potential to be an invaluable resource for strengthening the biological basis of acupoints and facilitating further integration of acupuncture into clinical care.
Malik adds, “We also know that there are many more whole-person therapies that can help restore optimum health in our patients, such as nutritional education or mindfulness. We are committed to supporting similar growth in those areas as well, so that all our patients have affordable access to a variety of integrative tools that can help them live not just longer – but better.”
