Herbalists seek to define standards and who should impose them.
If you were searching for an herbalist, how would you go about finding one? “In a perfect world, every community would have an herbalist who everyone knew and trusted,” says Aviva Jill Romm, executive director of the American Herbalists Guild (AHG) and the guild’s director of education and certification. Not long ago, lay herbalists tended the well-being of their communities without concern of credentials or certification. An herbalist was judged solely by his or her skill as a healer. Yet today, our society is dominated by credentials, says Romm, and community herbalists can be hard to find. Brigitte Mars, a longtime Boulder, Colorado-based herbalist, author, and faculty member at the Rocky Mountain Center for Botanical Studies, agrees. “If I wanted to find an herbalist, I would contact the American Herbalists Guild for a referral to a qualified practitioner,” Mars says.
But Rosemary Gladstar, founder of the California School of Herbal Studies and a well-known educator, writer, and activist in the herbal community, has a different point of view. “I would never choose a healer according to whether or not they had credentials. I’d find someone through word of mouth,” says Gladstar.
Up to this point, there has been no certifying organization for U.S. herbalists, and no standards for the practice of herbalism. The AHG wants to change that and is actively working to establish educational guidelines and a process of both registration and certification for herbalists. This raises a red flag for some herbalists who believe that certification will be detrimental to the practice of herbal medicine.
“I don’t think there’s anything that fires the herbal community up more than this controversy,” says Gladstar. “The decisions made about these issues will have a tremendous and far-reaching effect on the future of herbalism.”
The AHG was founded in 1989 with the intention of developing a professional organization for herbalists specializing in medical herbalism. Its stated purpose was to unify practitioners and to serve the public by raising the standards of herbal medicine and ensuring the competency of herbalists. From the beginning, though, there has been dissension around the issue of certification. Although the final plans for registration and certification are still in the works, the AHG intends to make both available by the end of this year. Meanwhile, the controversy continues.
“Many people are concerned about what certification implies,” says Roy Upton, vice president of the AHG and the legislative coordinator for the organization. “And some people have an inherent distrust of anything organized.”
According to the AHG’s plan, the title of “registered herbalist” will replace (and be equivalent to) its present designation of “professional member.” Currently, professional members undergo a review process by a group of peers who evaluate their education, experience, and training. Applicants must also demonstrate a minimum of four years of experience in working with clients and submit three letters of reference from professional herbalists.
“Certified clinical herbalist” is another title that registered herbalists or other health professionals such as naturopaths, physicians, nurses, Traditional Chinese Medical practitioners, or Ayurvedic practitioners may choose to pursue with the AHG. Applicants for this certification must pass a comprehensive exam that tests their knowledge of Western herbal medicine.
“This is specifically for people who want certification in Western botanical medicine,” says Romm. “We’re not in any way saying that a certified herbalist is more skilled than a noncertified herbalist, or that one has to be an AHG member to be a competent practitioner. We simply want to provide a way for an herbal practitioner to demonstrate competency in this one particular form of botanical medicine.”
“My belief is that it’s the caring of the healer that’s most important, but no one’s going to be able to test for that.”
—Stephen Buhner, herbalist
Herbalists wary of certification maintain that the practice of herbalism is an art as well as a skill, and as such, it cannot and should not be regulated in any way. Despite the care taken by the AHG to make clear its policy of nondiscrimination, opponents are concerned that the AHG is proposing standards that will inevitably create prejudice against herbalists who are not certified. Stephen Buhner, herbalist, author, and a former lobbyist on licensure issues related to herbalism and alternative medicine, is strongly opposed to certification and the educational standards that the AHG is proposing.
Buhner feels that the AHG is trying to institute a Western medical paradigm, but he doesn’t believe that a knowledge of Western medical science is fundamental to the practice of herbalism. “Human beings have used herbs for at least 60,000 years without a knowledge of biochemistry. The truth is that we don’t really know how and why herbs work,” he says.
Buhner adds that some people have made the assumption that a knowledge of biochemistry is essential for someone to be a good healer. “My belief is that it’s the caring of the healer that’s most important, but no one’s going to be able to test for that,” he says. “I think it’s fine for people to practice who are interested in biochemistry and physiology, but I also want to make sure that people who aren’t interested in Western medical science will still be free to practice.”
Christopher Hobbs, L.Ac., an herbalist, author, and educator, is in favor of certification but believes there are problems inherent in creating a test for certification. “If we adhere solely to the intellectual model of learning facts by rote, we automatically put some people, perhaps potentially good herbalists, at a disadvantage,” says Hobbs. “Just as some people are bright in the usual sense of intellectual prowess, some have a high ‘E.Q.,’ or emotional quotient. They are attuned to the more subtle, even esoteric clues that lead to insights that facilitate healing.”
According to Romm, the guild has no intention of excluding anyone. “We are working hard to make sure that we are respectful of multiple routes of entry, study, and practice. At the same time, we want to establish a meaningful standard,” she says. “We are upholding a standard of excellence, not one of exclusion.”
The certification exam proposed by the AHG is meant for those who are actively practicing herbal medicine. “It gives them a reference for where they are in their own set of skills and provides direction for areas they need to work on,” says Upton. “Our whole idea has been to increase our levels of professionalism, competency, and skill in what we do.”
Gladstar believes the intentions of the guild are good but questions the paradigm they are adopting for certification. “They are emulating the model used by most of our modern world, and I don’t see that it’s worked very well,” Gladstar notes. “It’s a model that hasn’t benefited the healing community or the people choosing healers. No matter what the intentions of the guild are, once the AHG standards are in place, it will force people to either join the ranks or become renegades.”
As one of the pioneers of the U.S. herbal renaissance that took place in the 1960s, Gladstar was instrumental in bringing herbalists together for gatherings at Oregon’s Breitenbush Hot Springs, where the seeds of the idea for forming a guild of herbalists were first planted. Yet she has resisted becoming a member.
“I never joined AHG, although many of the people involved are among my closest friends,” she says. “My not joining is my way of making a statement that it’s not necessary to join an organization to practice as an herbalist. You can do this work and be effective without being sanctioned by an organization.”
Romm concedes that certification doesn’t guarantee that someone will be a competent healer. “This is well demonstrated by our current medical system with its high numbers of [medically] caused injuries and deaths,” she says. “However, a credential does provide a guide for those seeking the care of an herbalist. Credentials offer some assurance that an herbalist has at least met a specific standard of education, knowledge, and experience.”
Romm adds that the AHG gets calls daily from its members, health professionals, consumers, and regulatory agencies requesting information about certification or certified practitioners. “We have people calling who want to know how to obtain a recognizable credential in botanical medicine, and calls from people seeking credentialed practitioners,” she explains. “We are responding to their needs.”
Some believe that certification will give herbalists more recognition by the current health-care system and that physicians, pharmacists, and hospital administrators want to see a traditional training and testing process akin to what they are accustomed to in the medical and pharmaceutical professions.
“We need community herbalists who are free to practice without fear of retribution, and we need trained herbalists in hospitals who are able to integrate herbs with standardpractice medical care,” Hobbs argues. “This will allow many millions of people to have access to high-quality natural health care, herbal medicine, and wellness-oriented practitioners. The certification process is beneficial because it will impel us to take a deeper look into how herbal medicine can serve the people, how it can work best with the dominant medical disease-care system, and perhaps reorient us toward more emphasis on prevention of disease and true health care.”
Opponents of certification fear it could lead to the same situation that occurred when the American Medical Association (AMA) rose to power and tried to suppress all other healing traditions. “Theoretically, eventually some state is going to pass a law regulating herbalists, and they may adopt the standards set forth by the AHG,” says Upton. “But we have a strong legislative position that we will oppose any legislation that would limit the practice of herbal medicine or the use of herbs to any one group, including certified herbalists.”
First and foremost, Upton believes, herbal medicine has to remain medicine for the common people. “We can’t turn it into a hierarchy like the AMA that stifles all other types of health care. We believe that naturopaths, lay herbalists, traditional cueranderos, Native American herbalists, traditional Chinese herbalists, Ayurvedic herbalists—all should be allowed to practice.”
The AHG position is that all practitioners are complementary to one other, Upton explains. “Everyone needs to know what their limitations are and needs to know when it’s appropriate to refer a patient to someone else.”
“If there are going to be some controls set on the practice of herbalism, then let it come from herbalists and not from doctors or some other outside group.”
—Aviva Romm, AHG executive director
Buhner, along with others who are opposed to certification, is concerned about what he sees as the next logical step following AHG certification: state regulation and restrictions on practice.
“For herbalists to be free to work, each state would have to recognize their profession in some fashion. Usually, the state legislature in question would pass a law that says that only licensed, certified, or registered herbalists can practice. And the only way they will do this is if they are convinced there is the potential for harm, and that they need to enact legislation to protect consumers,” Buhner says.
“We’re not moving in that direction,” counters Upton. “At some point, some group in a particular state might seek licensure of medical herbalists. But our key fundamental principle is that the guild will actively oppose any legislation that would suggest that a nonlicensed person could not practice herbalism.” Upton doesn’t think that herbalists will have to be licensed to be part of the current health-care system. He cites registered dietitians as an example of a professional group that has managed to avoid licensure by establishing standards for themselves. ‘We can do the same thing. With certification and registration, we don’t give up our power or autonomy. We decide on our own set of standards, and eventually, we will be recognized by the state,” he says.
Gladstar believes that the AHG is listening to those who oppose certification, and she acknowledges that the AHG is continually trying to adapt what they are creating to take those concerns into consideration. “But I see them still trying to use the old health-care system model that is currently in place that isn’t working,” she says. “We don’t need to repeat the mistakes that have already been made. Instead, we need to look for new solutions. This is a big issue, and it’s important that people speak up about their feelings now because things are being put into place that won’t be able to be changed later.”
Buhner favors using the same type of legislation for herbalists that has been enacted in Colorado and Washington to regulate the practice of psychotherapy, and a recent Minnesota law that grants freedom of practice to a wide variety of alternative health-care practitioners. In those states, the legislature says that anyone can set up a practice. But they do require that anyone who wants to practice has to be registered with the state (which is done by filing a form), and that everyone who practices has to have clients sign an informed consent statement. Informed consent means that a client is provided with a written statement disclosing the practitioner’s professional training and experience; standards of practice; expectations for both parties; fees and policies; and information as to how a client can file a grievance.
The AHG already encourages its professional members to practice informed consent and full disclosure. “This means that I give a client a piece of paper that tells how I learned about herbs, what I believe I can do, what services I can provide, my expectations of them, and what they can expect from me. I make it clear that I am not a medical doctor and that my suggestions are not to take the place of their doctor’s advice,” explains Upton. The intent, he stresses, is to clarify the relationship between a practitioner and client and to avoid possible misunderstandings that can lead to legal action.
“We definitely support informed consent and full disclosure, but to codify this would require a law—and then we change from being a self-certifying body to being certified by the government, and things can get scary,” Upton says. “The more we can keep the government out of the process, the better it will be for our profession.”
The AHG is definitely interested in hearing what people have to say about certification and registration, Romm says. “If the consensus in the herbal community is not to have certification, that’s fine with me,” she says. Romm is currently working for certification because that’s what she hears the majority of people—professionals, students, and clients—want. The other primary reason is that establishing some kind of standards appears inevitable.
“It’s a question of whether we do it for ourselves, or whether someone makes those decisions for us,” she says. “If there are going to be some controls set on the practice of herbalism, then let it come from herbalists and not from doctors, naturopaths, nurses, pharmacists, or some other outside group. One of the stated goals of the AHG is to increase communication and cooperation among herbalists. We heartily invite those who wish to participate in shaping the direction of herbalism to get involved. The future of herbal medicine in this country is in part, what we make of it. We have a terrific opportunity to work together to achieve planetary wellness.”
For more information, contact the American Herbalists Guild, 1931 Gaddis Road, Canton, GA 30115; (770) 751-6021; www.americanherbalist.com.
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