Is Choosing Herbs For Your Patients Difficult?

One of the questions, I get asked a lot is, what herbs do you use? And most often I say ‘’Tailored liquid extracts, because of their high patient compliance”. It is a very popular form of herbs and everybody loves them, especially children. They are taken with a little water two to three times per day, at least 30 minutes a way from meals. I modify most of my formulas as I prescribe according to signs and symptoms, palpation and pulse diagnosis.

Whenever I must use animal derived products, I will use granules. Animal substances (except shells) are not available in the liquid extract range. I also tend to use granules more in acute situations as often they only need to be taken for a few days.

Why I Use Dispensary Service

I choose not to dispense my own herbs and instead use the services of our licensed dispensary called Safflower. I am the founder of Safflower as I have a European background. In my home country Switzerland, every practitioner must use the services of an official pharmacy. Safflower has a GMP (Good Manufacturing License) from the TGA (Therapeutic Goods Administration) and is regularly inspected by those authorities. I have written a White Paper on some of the reasons and conflicts of interest that can arise for a practitioner doing their own herbal dispensing.

I prescribe tailored herbs for all my patients, so patents or ready-made formulas are not an option for me. Additionally, I see a lot of young patients (babies from 6 months old) in my clinic as well and consequently, my preference to use liquid extracts.

Prices for Herbs

Sometimes, when I speak to practitioners, I get told that using an herbal dispensary service is expensive and my first question always is: “Compared to what?”. Just looking at the prices for single granules, ready-made formulas or patents might not cut it as a significant amount of time is used for sourcing suppliers, ordering, stocking, cleaning, dispensing, packaging and labeling.

Another discussion that I often have with practitioners is that they say their patients are not able to afford herbs on top of the treatments. I am the first to acknowledge that for patients with chronic conditions, it might sometimes be difficult to pay for herbs over an extended period especially, if they are unable to work. I have been working in a regional area for over ten years now and despite of the fact that it’s considered a lower socioeconomic area, it’s uncommon that my patients complain about the price of herbs.

I have not prescribed or dispensed patents for some years now, but I have recently looked at some of their prices and compared it with a tailored formula from Safflower. I have found that a fortnightly supply is only around 25% less than a tailor-made granule formula (postage excluded).  If I was ever using patents, I would give a lot more than indicated on the package. To me, a therapeutic dosage is not in milligrams but in grams of herbs. The advantage with patents certainly is that they are manufactured, tested and packed according to GMP (Good manufacturing practice) and expected to be a good quality.

Ready-made Formulas in Conjunction with Single Herb Granules

Ready-made formulas that can be complemented with single herbs are certainly an economical option for practitioners but it’s important the costs for production, packaging and labeling is included in the calculation. The only limitation is the availability of AUSL formulas in Australia. Any ready-made formula requires the listing with the ARTG (Australian Register of Therapeutic Goods). In a business model, time, effort and resources for dispensing also must be considered as expenses and hence calculated.

Raw Herbs

Prescribing and or dispensing raw herbs is the way our forefathers have provided our patients with their medicines. I love taking them but, it’s not often that I use raw herbs with my patients. I will, however, if I am certain that the correct formula has been prescribed but the pattern is not shifting (e.g. the patient is not getting better). In such cases, I will consider using raw herbs if the patient is on board with the preparation of a decoction. Prices of raw herbs vary based on their quality. To be confident that raw herbs are free of unwanted contamination, a Certificate of Analysis (CoA) is required.

What’s the Point of All of This?

When deciding about a system of using or prescribing herbs for our patients in the clinic, we need to know the full picture. Once, we are clear on the way we want to work, then that’s what we commit to and apply in our clinical practice. I encourage you to use a system for some time before making too many changes. If you are unclear about how you should do your herbal dispensing, get in touch and I am happy to share my insight and experience with you. Also, consider, that financially it must work out for yourself and your patients as well. You might want to have a look at my article on the psychology on pricing herbs and services. I would be more than happy to receive feedback on how you tackle this topic.

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