Incorporating herbs into your practice can make a tremendous difference to your patients, your community, and your bottom line.

By Judy Weightman

If you have older patients, you already know that many of them are interested in how they can maintain and extend their wellness. “Anti-aging is an area where your interest is directly proportional to your age,” says Kerry Bone, director of research and development at MediHerb in Australia.

Bone continues: “I want to extend my health span, not just my life span. What’s the point of living to 105 if you’re sick and miserable for the last 25 of those years?

I’m not concerned about gray hair and wrinkles; I’m concerned about the killers: stroke, Alzheimer’s, heart disease. These are preventable.” Bone advocates a combination of lifestyle, dietary, and supplement advice as a means of maintaining good health.

Using herbs in your practice makes a lot of sense, according to Richard DeSoto, president of Kare-N-Herbs, a manufacturer and distributor of herbal supplements. “Chiropractors deal with patients on a one- on-one basis, paying attention to both the mental and the physical aspects of their situations. This is unusual in the wellness industry.”

The use of herbs can help in that one-on-one relationship. “Herbs can give quicker results in treating a patient’s symptoms,” Bone says, “which can enable you to win the faith of the patient and buy time for other treatments to take effect.”

“Herbs can be amazingly healing substances and often can serve as nice alternatives to synthetic drugs,” says Jamie Oskin, ND, who maintains a private practice in Arizona. “This can offer practitioners new tools and services to offer their patients, and have added value for the practice.” And of course, if you provide the products yourself, you can develop an additional revenue stream.

Getting started

First things first: “Check with your state board of medicine to make sure it is within your scope to prescribe herbs in the chiropractic setting,” Oskin advises.

If you have the legal green light, start small and expand cautiously. “Start simply, with just a few recommendations, like Echinacea and ginseng,” Bone advises. “Build this element of your practice organically: start now and build experience with a few herbs you’re comfortable in recommending. You’ll be able to deal with more complex problems as you gain experience and confidence.”

“Get to know the herbs, and understand their actions,” says Virender Sodhi, MD (Ayurved), ND, CEO of Ayush Herbs. “You need to not only look at the pharmaceutical action, but the effects they have mentally and emotionally.”

DeSoto also recommends starting with a tight focus, but on conditions rather than herbs. “Start with learning the herbs that help with a particular condition that you see a lot in your practice,” he advises. “If your patients complain of stress, learn about the herbs that help reduce stress, like Ashwaganda. If your patients are tired and lack energy, learn about the herbs with a tonic effect, like rhodiola. Herbs make a lot of sense for a chiropractor,” he says. “You know your patients. Know what their concerns are and how you can help them with maintaining wellness, not just curing sickness.”

Whatever your starting place, herbs, or conditions, “Make sure you have an adequate library, whether digital or paper,” Bone says. “Find good, reliable sources and references. It’s OK to use the Web, as long as the information is reliable — don’t just Google the name of the herb.” There’s a lot of bad information online, he warns. “Be guided by clinicians. Don’t rely on information from people who don’t see patients, because their information is just theoretical, so it can be incomplete or just plain wrong.”

According to Bone, there’s very little to be afraid of when it comes to prescribing herbs: “Follow some basic rules, but most of the safety risks are extremely remote and theoretical. Herbs are not absolutely safe, but they are inherently safe,” he says. “As long as you use good common sense, there are no impediments to prescribing them.”

Tips for success

One of the basic rules is to ask about all prescription and over-the-counter (OTC) medicines and supplements that your patient is already taking. “Make sure there are no drug/herb interactions or contraindications for the herbs,” Oskin says. “For instance, a commonly used OTC herb for depression is St. John’s wort, which has many drug interactions”

that are not limited to prescription antidepressants.

Even patients who aren’t taking any other medications might have conditions, such as high blood pressure, that contraindicate the use of particular herbs. Women who are pregnant or nursing should be especially careful about the supplements they take. Be familiar with the effects and common side effects of any herb before you prescribe it.

This reflects the importance of using a reliable source of information for contraindications and side effects. “Misinformation is one of the biggest pitfalls,” Bone warns. That includes misinformation that your patients find on their own.

“The Internet is a blessing and a curse. I’ll prescribe something, and they’ll call back and say ‘Why did you prescribe this for me?’ after they go home and look it up online. There’s so much misinformation out there,” Bone says. Educating both yourself and your patients is crucial.

When you do prescribe an herb, make sure you prescribe enough of it to be effective. “New practitioners often fail to give a high enough dose,” Bone says. “They need to look at the percentage of active phytochemicals in a product, not just the size of the capsule or dose.”

Buying and selling herbs

By providing the herbs yourself, you can develop an additional revenue stream for your practice. Just as importantly, though, you can ensure that your patients are getting the best quality products, which will add to the herbs’ efficacy. One thing that all the experts agree on is the importance of using a quality product.

Bone recommends using professional-only products. “They’re created by clinicians for clinicians, and have more quality built into them.” Specifically, he says, “you want to buy from a company that is strong in phytochemistry.”

It’s important to use reputable companies, because unscrupulous providers have been known to sell adulterated products that use less-potent parts of the plant, or less-efficacious species or varieties of the plant. “Buy from a manufacturer who is aware of these issues, who has an active lab, and who is using that knowledge and those resources,” Bone advises. By selling the herbs yourself, you ensure that your patients are getting quality products.

Like prescribing herbs, it’s best to start slowly with selling them. As Oskin points out, “Managing an office medicinary can be challenging.” It’s not only figuring out what to buy, but staying on top of an inventory with a limited shelf life; unsold products can go past their expiration date.

Oskin recommends options like pre-made formulas in liquid tinctures or in capsules, dry bulk herbs, or large tincture bottles of individual herbs. He says, “I would suggest while beginning to learn about herbs to keep your medicinary small so that you don’t have a lot of cash tied up in inventory sitting on your shelves. Start with a modest inventory of herbal products you will use regularly, and slowly add to your medicinary as you gain more knowledge and skill in your herbal prescriptions.”

If you’re not going to sell the herbs yourself, counsel your patients about the importance of quality. “Many patients want to buy the least expensive brand,” DeSoto says. “They’ll go to the supermarket or drugstore, where there’s no trained staff.”

Instead, DeSoto advises patients to go to “the mom- and-pop health store,” whose owners have been in the business for decades, and who often originally went into it for personal reasons. These stores can give the consumer knowledgeable advice. They’re also more likely to carry products from Europe, which has higher production standards than the United States.

Endless opportunity

By adding herbs to your practice, you can serve your patients better while adding a new revenue stream. As long as you observe some commonsense safety precautions, there are very few risks and a lot of potential benefits.

“The use of herbs represents a tremendous opportunity,” Bone says.

“There are not only medical benefits for the individual, but social benefits for the community, because healthy people are less of a burden on the healthcare system. Helping people with anti- aging strategies can lead to the increased happiness and well-being of the entire community.”

Judy Weightman is a writer and editor based in Philadelphia. In addition to health, she writes on higher education, gardening, and sustainability for both print and the Web. She can be contacted atjmweightman@gmail.com or @JudyWEdu.