License to practice?

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People who want to use medicinal herbs may turn to an herbalist for advice. But what they can’t tell by the term “herbalist” is how qualified the herbalist actually is.

While some herbalists have years of education and experience behind them, ­others may have taken only a two-day course via the Internet. And the discrepancies in qualifications and experience don’t end there.

As diverse as the tradition of herbalism itself are the people who practice it. Anyone, from traditional healers to herb growers to grandmothers, can call themselves herbalists–and they do.

“Herbalists fight bitterly among themselves about who an herbalist is or isn’t because there are so many different kinds,” says Amanda McQuade Crawford, president of the National College of Phyto­therapy in Albuquerque, New Mexico. She also is a founder of the American Herbalists Guild (AHG), a national organization formed in 1989.

Seeking continuity

AHG members want to set themselves apart from other herbalists by specifying a title that would guarantee a certain level of competency gained through both education and experience.

By regulating their profession and defining their scope of practice, members say, they will be able to participate more freely in the American health-care system.

In England, clinical herbalists have been registered since the 1860s with the National Institute of Medical Herbalists (NIMH), a successful organization that has evolved over the decades to meet changes in society. Herbalists like Crawford, who is a member of the NIMH, wonder whether it isn’t time to establish a similar organization in the United States, and some consumers agree.

“I wouldn’t go to an acupuncturist if I didn’t know they were qualified,” says Andrea Johansen, a doctor of oriental medicine in Fort Collins, Colorado, who uses medicinal herbs in her practice and personally. “And herbs are dangerous as well as powerful. [Herbalists] should be well-trained.”

In addition, AHG members and others say, consumers often buy herbs without knowing much about them. So they turn to their pharmacists and licensed physicians for advice, although these medical professionals may not be trained in herbal medicine. The most qualified individuals to steer consumers in the right direction are well-trained clinical herbalists, says Mindy Green, education director for the Herb Research Foundation in Boulder, Colorado. Adds Crawford: “Our real interest is in protecting the consumer so they can make an educated decision about who not to seek.”

Hoping to protect their profession

Another reason why AHG members are considering regulation is fear that those who take only short courses in herbalism and those who give recommendations without training in herbal medicine pose a threat to the profession, says K. P. Khalsa, a clinical herbalist based in Seattle and AHG treasurer.

“There’s a dawning reality that if we don’t create recognition and cohesion for our profession, our skills will be taken by others,” Khalsa says.

At the same time, AHG members say, they want to avoid regulation by lawmakers who, in response to the rising use of medicinal herbs in the United States, may soon step in with their own proposals for regulation. Such rules may not fit the unique approach to medicine that herbalists take, some say.

“If we don’t set standards and guidelines for ourselves, they will be pushed on us by an outside entity,” says Steven Horne, AHG president and executive director. Herbs don’t fit the typical medical paradigm, he adds; rather, herbalism involves a more philosophical approach.

In an attempt to monitor their profession, in 1996 AHG members adopted a practice called “informed consent,” in which unlicensed practitioners govern themselves. Herbalists pledge to be straightforward with their clients about therapeutic aims, and clients either accept suggestions or they don’t before any treatment begins.

Currently, AHG members are considering additional proposals for regulating their profession: licensure, registration, and certification. All three approaches exist to varying degrees in some, but not all, states. AHG members say they would like to back these titles up with requirements in all states that are monitored by a third party. One aim would be to make the “registered herbalist” credential similar to that of a registered dietitian.

Jeopardizing tradition?

Not all herbalists agree that regulation would be good. Some fear it would ostracize many highly qualified herbalists who disagree with the AHG’s standards, including self-taught herbalists born of the herbal medicine revival of the 1960s and 1970s, as well as traditional and ethnic healers who receive knowledge passed down from generation to generation.

“The trend of herbal medicine is so rich and so deep that we run the risk of excluding others,” says Shelley Torgove, clinical herbalist and owner of Apothecary Tinctura in Denver, Colorado.

Carolyn Robinson of Fort Collins, a consumer who would rather find a competent herbalist through word of mouth, agrees.

“Regulation might be scary because it could end up hurting people who have the knowledge,” she says.

AHG members acknowledge this concern but say that regulating their profession is a necessary response to changing times, and that their intent isn’t exclusion. Nor is it to take business away from herbal supplement suppliers, who may be concerned that the registration and licensing of herbalists will take herbal products out of the marketplace and into the hands of certified herbalists.

“Herbal medicine has always been medicine that the common person has access to,” Horne says. “We don’t want to prevent someone from access to herbs.”

Some consensus

Finally, despite the differing opinions among herbalists about regulation, Craw­ford says that most herbalists agree on the definition of ethical and responsible practice.

“No group should own the term ‘herbalist’,” adds Roy Upton, AHG vice president. But, he continues, “a ‘registered herbalist’ would mean something specific.”

AHG members currently are investigating the different methods of herbal practice and plan to recommend one approach in one target state, which would become a model for other states to follow. In the meantime, group members are working on education guidelines for a national certification test for knowledge and competency among clinical herbalists.

Sarah Kelch will graduate in May from Colorado State University in Fort Collins, where she is majoring in journalism and graphic design. She is a former Herbs for Health intern.

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