1. How often do you prescribe herbs?
In general, I recommend waiting to invest in an herbal pharmacy until your practice is more established, so you can evaluate the types and quantities of herbs you’ll be using. I see many new practitioners move locations in the beginning of their career. Once you’ve established some roots, an herbal pharmacy will require around 10 patient visits a week to be practical.
*There are natural exceptions to this; as an intern I was focused on herbs and regularly prescribed formulas to my patients (and my family, pets, and anything else I could convince to take herbs), so I knew that herbs would be central when moving into private practice. Many patients continued to see me after graduation, so I was lucky to be busy enough to keep a stock of herbs that expanded as my patient base grew.
2. Do you prescribe custom formulas or patents?
If you prefer to prescribe custom formulas, which I recommend, then you will need to focus on stocking raw or granule single herbs. Custom formulas give greater clinical results and allow you to treat a wider range of cases compared to patents, but they require more space and equipment necessary to store and assemble your formulas.
Patents can be more convenient than making custom formulas; here you trade convenience and fewer storage and equipment needs for a more limited scope of therapeutic interventions. Liu Wei Di Huang Wan treats kidney yin deficiency, for example, so you will need to choose if you want to carry it as a pre-made formula or stock its ingredients that can be used to make a wide family of formulas. I used to carry formulas in the beginning, however I quickly found them to be too limiting compared to the advantages of stocking single herbs.
3. What type of space will your office have?
Raw herbs need more space. Granules require ventilation. All herbs require a sink, as well as table-tops and storage for equipment and supplies.
I prescribe custom formulas 90 percent of the time, so when opening my practice I chose an office that had the utilities and just enough storage space to keep a granular pharmacy of about 325 single herbs. I prefer granules for several reasons–they store well and require less space than raw herbs, have a high patient compliance, and are overall easier to work with when giving customized formulas.
4. What type of herbs will you carry?
Each type has its advantages and disadvantages, so it’s important to know what you will be treating and what herbal types are going to be the most useful to you. Check back next week for the advantages and disadvantages of each type!
5. What type of cases do you see in your practice?
If you are stocking single herbs or patents they should match the majority of case types presenting in your clientele base.
I specialize in fertility, so the majority of my inventory pertains to categories such as spleen and kidney deficiency, qi stagnation, blood deficiency, and securing the fetus. My associate, Kirk Pfeiffer, who is a pain specialist, carries a wide variety of plasters, patches, liniments, and tinctured formulas such as Du Hou Ji Sheng Wan and Shen Tong Zhu Yu Tang. These are differences in style that should be reflected in the herbs and herbal products you carry.