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— updated 2004-09-28

Herbalist Review, Issue 2004 #2: Minimize the costs of becoming an effective herbalist

by Roger W. Wicke, Ph.D.

In herbal education, the practicalities and demands of real clinical practice are too often ignored in favor of curriculum padding to favor theoretical speculations that impress only the academics.

Subtopics on this page…

Copyright ©2004 by RMH-Publications Trust; all rights reserved.

If you are interested in becoming an effective clinical herbalist, this report answers several important questions that may greatly impact the cost of your education.

Minimize the costs of becoming an effective herbalist

Background - American health care in crisis

"We do not need any more medical advances/drugs. We, as an American economy, cannot pay the exorbitant sum to fund projects that we objectively cannot afford anymore. We cannot afford $20,000-a-month novel cancer treatments. We cannot afford to extend people's lives past age 100 because Medicare and Social Security cannot afford to subsidize it. The very tight NIH and NSF funding on all levels of math and science amply reflect this, perhaps rightfully so."

The preceding quote is from a letter written by a young Ph.D. scientist to economist Robert Gordon, who compares the current excesses and distortions in the American economy and with those of the Great Depression.

An aspiring herbalist, to best serve the public and make an honest living, needs to consider the current economic, political, and social forces that may either enhance or impede one's goals. Currently in America and other developed nations, health care is facing crises on multiple fronts that will affect the people of these nations and their health care workers. The deterioration of the American health care system, in spite of greater expenditures per capita than any other nation in the world, has consequences that affect the way natural and alternative health is practiced in this country.

Consider the thousands of people each year who have triple bypass surgery for coronary artery disease. Even many physicians, as well as alternative health practitioners, now recognize the importance of diet in controlling and alleviating this disease. Many people have avoided such surgery with only a few hundreds of dollars of herbs and diet changes. In my own practice, I've witnessed clients whose doctors administered angiograms before and after the use of herbs, verifying the effectiveness of herbs and diet changes in these cases after only a few months.

What is shocking is how many people refuse to consider making dietary changes or taking herbs costing only a few hundred dollars, because their health insurance does not cover these. Yet they may choose to subject themselves to risky and expensive surgery (>$50,000) that often needs to be repeated every few years after the arteries again become occluded. Coronary artery disease is only one of a long list of chronic illnesses (cancer, diabetes, hypertension, autoimmune diseases, arthritis, and many others) for which lifestyle and diet factors play a significant role, and for which herbs can be useful. Yet many sufferers continue to choose expensive and toxic medications and treatment options, neglecting more cost-effective options, because the insurance system supports and encourages these wasteful choices.

The economic and financial systems of the Western world have become mired in excessive speculation, waste, and a destruction of basic infrastructure, a process that some economists have documented as beginning in the 1970's. Health care, basic industry, bridges, railways, sewer and water systems, and power infrastructure have all seriously deteriorated. Inner-city hospitals have closed down. HMO's ruthlessly terminate the policies of patients most as risk. Low-income families can no longer access pre-natal care and emergency services while pharmaceutical companies focus their efforts on designing drugs for the yuppie, baby-boomer crowd - drugs for impotence and mood enhancers are all the rage, to keep people in a state of chemically induced good cheer. The international financial system today resembles more a gambling casino than a common-sense framework for investing in human needs. A get-rich-quick fever has infected every facet of the economy and drives decisions at major health care institutions and corporations.

An increasing number of Americans are beginning to recognize the Potemkin-village illusion of American health care, and are deserting the system en masse, just as the corporate-profit-driven medical system has turned its back on many individuals, leaving them without essential health care services. As responsible herbal practitioners, we need to focus on these people. It may be years before the mainstream medical system collapses of its own failings and excesses, but in the meantime, huge profits will continue to distract many from real solutions. [1a] Unfortunately, I predict that many will not acknowledge reality until a major economic shock collapses the speculative excesses inherent in our current medical system.

Cuba, a case study in surviving economic shock - a health-care revolution

Cuba's medical and health care system, prior to the 1990's, was typical of many Communist nations. Cuba attempted to emulate the scientific, Westernized medical systems of developed nations, simultaneously suppressing indigenous medical and folk traditions, as such were seen by the Communist bureaucrats as holdovers from pre-revolutionary superstitions. The idealized view of the modern Communist state as being driven from the top down by scientific principles of management is in reality very similar to the ethos promulgated in American business schools such as Harvard, Wharton, and MIT. The result of this top-down, corporate-government management style has been to transform the public in all developed and developing nations into loyal consumers of corporate-backed scientific medicine. (While the scientific and medical innovations of sanitation, water treatment, quarantining of epidemic illnesses, and public education in basic nutrition can be credited with significant improvements in public health worldwide, the suppression of indigenous herbal and dietary traditions, the excessive use of antibiotics without specific diagnosis of infection, and the introduction of highly processed synthetic foods have negated many of these benefits.)

In the early 1990's following the economic and political collapse of the Soviet Union, Cuba struggled to survive the cut-off of financial aid and trade with the former Soviet Union, and its medical system, like all other sectors of its economy, was forced to make draconian cutbacks in services. The continued American embargo of Cuba further exacerbated these cutbacks. Unlike many nations that disintegrated under such economic shocks, the Cuban government and people responded with creativity and common sense, choosing to turn economic crisis into opportunity by transforming dependency into self-sufficiency.

In a short period of only a few years, Cuba transformed its entire medical and health care system by resurrecting a wide variety of alternative health practices. [2a, 2c, 2d, 2e, 2f] Recognizing that much of the indigenous knowledge of native herbalists had been lost during the decades under Soviet communist influence, Cuba instigated a crash program to restore knowledge of native herbs and to import medical knowledge from China. Traditional Chinese medical doctors were brought to Cuba to teach the Chinese system of clinical herbology, acupuncture, tai qi, qi gong, and other healing arts.

Implications for America

The transformation of Cuba's health care system has been a result of necessity. Issues of capitalism vs. communism are red herrings and are irrelevant to this discussion, as both economic systems have been afflicted by a tendency to suppress independent, indigenous health traditions in favor of bureaucratic, westernized medical systems prone to distortions benefiting an economic elite. While people worldwide have until recently been trained by the international media to focus on a staged battle between the forces of Capitalism and Communism, the real battle now facing people worldwide is one of global corporatism vs. individual freedoms. [3a] While Cuba continues to suffer under the ministrations of an autocratic government, in the realm of health care Cuba's government has demonstrated common sense born of necessity.

Forms of alternative health care, including herbal medicine, have been popular in America since the flower-child, back-to-nature revival of the 1960's. Unlike pre-1990's Cuba, alternative health in America has been alive and well for many decades. What remains to be seen is how quickly American alternative practitioners can overcome the increasing distortions in our economy resulting from decades of irresponsible speculation and consequent collapse of our health-care infrastructure. Specifically, will these practitioners attempt to cater to the trendy illnesses of a shrinking economic elite - impotence, mood disorders, cosmetic enhancement - or will they recognize the reality of economic decline and collapse and prepare to serve the basic survival needs of the population? Many Americans can no longer afford health care insurance; the wonders of the Potemkin village of modern scientific medicine are not accessible to them. We should all be ashamed of the wasteful and bloated American economic system that has resulted in a deteriorating health care system than many Americans can no longer afford. How close to the precipice must America come before the health community at large accepts a dose of reality?

The challenge is for individuals to recognize that the speculative excesses of the last few decades cannot last. I won't attempt to prophecy when the transition will occur, but if history is any guide, American-style health care systems that fail to meet basic health needs of the population, while offering services of debatable value at outrageously inflated prices are doomed to collapse of their own failings and excesses. As herbalists and natural health care practitioners, we can only step aside and remove ourselves as much as possible, legally, politically, and economically, so that we can offer our services at reasonable cost to those who need them. The remainder of this article discusses specific ways that, as a student of clinical herbology, you can avoid getting into unnecessary debt, minimize your educational expenses, and focus on attaining practical clinical skills that will make an important difference to your future clients.

Rather than wait until the majority recognizes the status quo has changed, foresighted herbalists should prepare themselves to offer effective, low-cost health care that will be in demand in an era of economic austerity.

Common misconceptions about requirements for becoming an herbalist

Is a license required to practice as an herbalist?

In the USA and in many other countries, herbalists (including TCM-style herbalists) do not require any license to practice. For a summary of the regulatory situation in specific countries, see:

Herbal medicine worldwide is typically one of the least expensive health care options, and one reason for this is that is remains largely unlicensed in many parts of the world. Licensed professions typically invest huge financial resources in protecting their economic turf and these investments are reflected in increased costs to patients and clients. (See Stephen Buhner's article [4a] documenting how professional licensing and regulation seldom result in improved health care delivery, but are almost always guaranteed to increase costs, to minimize competition, to reduce the public's freedom of choice, and in some cases, to actually decrease quality of care.)

There are thousands of practicing non-licensed herbalists in the USA alone - Ayurvedic, Chinese, Western-style and others. While some professions such as naturopathy are licensed in some states, this does not preclude others from using and recommending herbs to improve health - just don't call yourself a naturopath if you are not licensed as such. Most licensed health professionals, except physicians, and all unlicensed health practitioners must avoid "practicing medicine" without a license, as the licensure statutes in most states do not allow acupuncturists, nurses, massage therapists, and chiropractors to generally diagnose diseases - their scope of practice is usually defined very narrowly.

The bottom line is that a state-granted license to practice some specialty of health care does not necessarily preclude one from needing to know the legalities of what constitutes "practicing medicine". Avoiding the practice of medicine in America (and in many other countries that observe English common law) is actually very simple - one should adhere to the following guidelines in all communications with clients:

  • Do not refer to yourself as "doctor" (even if you have a Ph.D.) or allow your clients to call you "doctor", as you could be accused of misleading your clients into believing that you are a medical doctor.
  • Do not make any claims to diagnose, treat, or cure any disease or medical condition.
  • You can provide health education and recommend (not "prescribe") herbs and foods for improving health.
  • Do provide each of your clients with a truthful, accurate summary of your education, experience, and qualifications, including any professional or educational certifications. (Some states in which Health Freedom acts have been passed require this in written form. In any case, it is a good idea.)

The following two articles explain these principles in greater detail:

Students at RMHI receive training in how to protect their rights as herbalists. Moreover, RMHI actively supports the growing Health Freedom movement internationally and opposes any attempts to restrict or monopolize the practice of herbology. We do support self-regulation and certification to promote improved standards in clinical care and in manufacturing of herbal products.

What is "certification"?

Certification is merely a statement of fact, written on a piece of paper, and signed by someone who can vouch for the accuracy of the statement. A common example is a certificate of completion signed by the president or director of a school attesting that the named graduate successfully completed a program of study. There is nothing magical about certification, and such certification is meaningful only if the school or organization requires a realistic standard of quality to obtain the certificate. With grade inflation, lowered educational standards, and the awarding of certificates merely for having sat in a classroom for a specified number of hours, certificates of completion from even accredited schools and colleges may not be the guarantee of competence they once were even 30 years ago. [3a]

Certification, which can be done by any private person or organization, is not the same as licensure, which can only be granted by a government body, typically an agency of the executive branch of government authorized by the state legislature.

Certification is only as meaningful as the integrity of the institution or individual signing the certification. RMHI certificates are only awarded to students demonstrating competence and passing objective exams that measure important clinical skills. Our graduates have served as faculty at major colleges and health institutes, served on international consulting committees, and are in demand in the herbal manufacturing industry, as well as serving as private consultants to individuals seeking to improve their health.

What type of person makes a good herbalist?

Because there are no required standards for calling oneself an herbalist, people who are seeking the services of an herbalist should take careful note of the educational background and experience of the practitioners they choose.

Many of the best herbalists I have known are individuals who are largely self-educated, regardless of how much formal education they have had. Life in the industrialized nations has become so complex and fraught with environmental and dietary toxins, that diligent practitioners will continue to study and learn after graduating. Good herbalists also have a keen sense of nature and pay attention to their senses, intuitions, as well as using common sense and reason to help their clients overcome often complex health problems. Mass education tends to be good at churning out technician types who are helpless if a problem does not match a textbook definition with its cookbook solutions.

Most course participants at RMHI are health professionals (physicians, pharmacists, naturopaths, etc.), and all are motivated inviduals capable of studying a large amount of material on their own time. Distance learning programs such as that at RMHI are ideal for busy health professionals who cannot take time off for full-time study. Health professionals will find that their clinical experiences will mesh nicely with the TCM perspective and will allow them to learn the course material faster than those without such background. RMHI does accept a small number of highly qualified non-health professionals - minimum prerequisites include having completed human anatomy and physiology courses elsewhere as well as demonstrating a strong prior commitment and interest in health.

Our programs emphasize self-study, reserving seminars for those students who have adequately prepared beforehand. Seminars focus on developing skills that require practice with actual clients. Because much of the textbook material is learned by self-study, the costs of an RMHI education are greatly reduced in comparison with conventional colleges.

Does a TCM herbal practitioner need to know acupuncture?

No. Historically, Chinese herbology and acupuncture are distinct techniques, just as massage therapy and herbology or homeopathy are distinct techniques requiring different training and skills. In China, it has always been common to find practitioners who practiced herbology but not acupuncture. Though these two disciplines are based on a common philosophy and some common terminology, the practical details and techniques are very different. While it is possible for some to become masters at both techniques, in practice this is rare. Most practitioners find themselves focusing on one or the other.

See the following article for more information about the historical differences in the development of Chinese herbology and acupuncture, and why common sense dictates that the qualifications and certification for each should remain separate:

How do you satisfy distributors you are competent to use their herbs safely?

None of our graduates, even the unlicensed herbalists, have had problems obtaining the herbs they need. Some Chinese herb distributors and wholesalers will state that they only sell to licensed practitioners, but in the majority of such cases, these distributors agree to sell to RMHI graduates who explain where they studied and send a copy of their graduation certificate. Many Chinese herb distributors are familiar with our reputation and our insistence that our students pay close attention to contraindications, herb quality, and safety.

Ethical herb distributors are rightly concerned that you will use their products safely, and the real issue is one of competence rather than whether you are licensed or not. There are a large number of unlicensed, non-acupuncturist, ethnic Chinese herbalists on the US West coast alone, and any herb distributor that refuses to sell to such practitioners would be foregoing a large amount of business.

How do you communicate your qualifications to the public?

While a majority of the American public regularly uses herbs, many of these people do not necessarily patronize herbalists for advice. In many other nations, where people have not forgotten their native traditions, this is not as much of a problem, and community herbalists offer familiar alternatives to allopathic health care. In America, where knowledge of herbal medicine was actively suppressed for many decades [5a, 5b], a major factor behind public hesitation to patronize herbalists is the general awareness that an "herbalist" can mean everything from someone who woke up one day and decided to call him- or herself an herbalist, to one who has had extensive and rigorous training. Another problem is that there are lots of "academic" herbalists who write books after reading other books, yet who have surprisingly little clinical experience.

On graduating from RMHI, it is important that you prepare a written summary to give to potential clients that accurately outlines your educational background and training, emphasizing that the RMHI training you have received is heavily focused on clinical cases and problem-based learning. (In contrast, much of traditional TCM education is still based heavily on rote memorization of data without understanding its clinical context.) Levels 2 and 3 of the RMHI training require you to submit detailed analyses and progress reports for clients you have worked with independently. Moreover, Level-1 certification, unlike at some schools, is not awarded merely for attendance or completion of make-work exercises, but requires passing an objective exam that tests pattern-recognition skills very similar to the types of skills required by a good clinician. (This is achieved with proprietary and innovative testing software that goes far beyond the capabilities of simple multiple choice exams.)

Comparing the costs of education

The cost of completing all three levels of training at RMHI is under $6,000; compare this to an estimated $80,000 for a 4-year education at a typical TCM/acupuncture college! (If your primary interest is herbal medicine, why unnecessarily inflate the cost of your education to learn acupuncture, when many acupuncture/TCM colleges cover herbology only as an afterthought?) Education at US colleges and universities has been hit by an inflationary trend that far exceeds the general inflation rate. While students at these colleges and universities may qualify for loans to cover the burdensome cost of such tuition, this reminds me of the people who choose the $50,000 triple bypass surgery over $200 worth of herbs because herbs are not covered by their insurance plan.

If your primary interest is to become a competent TCM-style herbalist, and you possess the self-motivation necessary to complete assignments required in the RMHI distance-learning program, why pay outrageous sums of money or go into debt slavery to learn the same material? Here are three reasons why we can offer a comprehensive program at minimal cost:

  1. We've put most of the printed course material and reference databases on a CD-ROM, and we admit only mature students and health practitioners who have the ability and self-discipline to read and study textbook material on their own time. (On-line discussion groups provide you with an opportunity to ask questions of instructors, other students, and RMHI affiliates.) Our seminars and classes are reserved for hands-on, case-based learning, and only course participants who have adequately prepared beforehand are admitted to the seminars. Rather than use valuable class time for rote memorization and routine lectures, our on-site seminars focus on helping you gain experience in solving clinical problems, as well as learning TCM-style pulse palpation and taking thorough case histories.
  2. We invest very little of our resources in bureaucracy. (Our only bureaucrat is a faithful Macintosh computer who handles all of our administrative requirements.) Our staff focuses their efforts on creating state-of-the-art educational software and course material to help you learn better.
  3. We use the Internet to full advantage, using it to create an interactive learning environment that reaches you anywhere in the world.

If you are not someone who can learn basic material well with self-study and distance-learning, then the RMHI program is probably not right for you.

$6,000 may seem like a lot of money, but if you are a motivated self-learner, $6,000 (estimated total cost for all 3 levels of our training programs) is a huge savings over $80,000 dollars in tuition. Moreover, you can get the complete text and reference material used in the program by ordering HerbalThink-TCM; you don't have to be an enrolled student at RMHI to obtain this software - anyone can buy it. The software contains the equivalent of many individual textbooks, and includes course materials, textbook chapters, reference materials, and interactive-learning software developed over a 15-year period; these materials include crucial information on diet and environmental health issues rarely covered in conventional TCM training programs.

"The course, the learning system, and the program simply have no equal. Pattern diagnosis is the foundation of TCM and the hardest aspect to learn. Points can be learned and herbs memorized, but all acupuncture and herbal treatments rest upon the pattern diagnosis. All patient conditions and presentations are not static and therefore the pattern diagnosis is not static. The RMHI presentation and computer program teaches you to recognize TCM patterns from the changing information of the signs, symptoms, tongue and pulse. You then learn easily how to apply this information to herbal treatments. It is brilliant and fun, because it is really a GAME in which you learn a TCM pattern diagnosis and herbal treatments. It is a GAME played with signs, symptoms, pulse, and tongue findings in which you are challenged, surprised, delighted, and assisted to learn and win. There is nothing like it anywhere for learning TCM."

— Matthew Hawkins, MD, Professor of Medicine, Case Western Reserve University, Ohio

Read more comments and reviews from physicians and other health professionals who are using RMHI's CD-ROM-based course materials.

  • How to get started (FAQ) - This step-by-step guide explains RMHI's prerequisites for enrolling, how to get started, and other frequently asked questions about preparing yourself to practice as a clinical herbalist.


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