Guest guest Posted January 26, 2007 Report Share Posted January 26, 2007 Love to hear from others on their thoughts... Bob www.acuherbals.com Well, since you ask. . . I must say i was alarmed when i saw your sight. i don't agree that chin. herbs should be made avail to the general public. i feel they should only be dispensed by a qualified herbalist. and by that i mean someone who has graduated from a TCM program in chin. herbs, and has taken board exams (NCCAOM or equivalent) to show competency in chin herb. i don't not agree that one should be allowed to prescribe chin herbs with acu only training, as is the case in my state, NC. as for selling herbs on-line, you have to practice in a way that is legal, ethical and comfortable for you. personally, i would not feel comfortable dispensing chin herbs to joe public without knowing anything about him. i wonder as an AP if you could be legally liable for malpractice if someone were harmed by taking herbs purchased at your web store? i wish mayway would only sell herbs to practitioners, and would not distribute them to health food stores and catalogue houses, and do not patronize their company because of this practice. i have not seen herbal times avail. over the counter, are they aware that you are selling their products OTC in an on-line store? likewise, i do not agree with dispensing policosonol or chin. red yeast rice OTC. you have no idea who's taking it, and whether they should be taking it without seeing their blood chem. that's my opinion. i'm sure there are others, like yourself who feel differently. i feel this practice harms the profession. kb On 1/25/07, Bob Linde,AP, Herbalist <boblindeherbalist wrote: > > Legally herbs are regulated as foods, so long as no western medicine > claims are made there is no real regulation. Herbalism is completely > unregulated....you may have it as part of your scope of practice but that > does not restrict herbalists from practicing with little or no training. > Many herbalists practice TCM sans the needles because the language that we > use allows them to avoid the pitfalls of western medicine claims. > As to the ethical end of it, it is something that I struggled with. I felt > that I made clear distinctions as to how to choose each formula and > mentioned cautions as well as possible side effects. So far internet sales > have been slow mainly because I don't really focus much energy on promoting > it yet. So far in the one year I have had it up no one has tried to order > anything I consider unsafe without a diagnosis...well other than a few folks > looking for formulas with Ma Huang or bulk Ma Huang....I have both but would > never sell to the public and have never actually prescribed internally (but > reserve my rights to use and buy it if I want!) > Without a doubt it is a difficult issue that has no good answers. At the > moment the webstore pays for itself and that is about it. Most of the orders > do come from small towns that I have never heard of that likely have no > access to APs or herbs so for them its a great service. We are still a very > small company so I am able to keep close tabs on what goes out to who. So > far no one is abusing anything. > Love to hear from others on their thoughts... > Bob > www.acuherbals.com > < <%40>> wrote: > Kath- > > I think this is a great question. I have often pondered selling herbs on > my own website (which is currently still just a dream), and have wondered > how I would handle the professional aspects of proper pattern identification > and prescription when I cannot personally see/hear/smell, etc. the > prospective " patient " to confirm what they are telling me, and would be > lacking these sensory clues which often prompt me to ask questions I > otherwise might not think to ask. I know there are many acupuncturists, and > even people who are not acupuncturists who sell Chinese herbal formulas > online, and I don't know how they do it - ethically, legally, and > professionally. Also, there is the aspect that many herbal manufacturers > attempt to prevent this sort of sale, and I don't know how those who do sell > herbal formulas online get around that. If there's anyone on this list who > does this, I'd like to know your thoughts and experience with it. I know > this discussion is one potentially > big can of worms, but I think it is worth talking about. > > My father recently was looking for information about Haradas disease > treatments for my sister, and found a group of acupuncturists online > operating out of England, who sell pretty potent herbal formulas with the > only requirement being a health history form to fill out. There is no way to > call them, yet they say they will modify your formula based on your > questionnaire. Their disclaimer is that they do not recommend herbal use > without a personal consultation, but they do not require it. When you buy > their herbs, they sell 6 months' worth at a time, for several hundreds of > dollars. I looked at the formula they had for Haradas disease, which > included many of the herbs I would have thought to use for that condition as > it is described in medical journals, but those descriptions do not at all > match my sister's pattern differentiation. It was a good learning experience > which made my hair stand on end and also prompts my questions here. > > > > " " <acukath <acukath%40gmail.com>> wrote: > i looked at your website and noticed you're selling chinese patent herbs > and > other products on the web. do you require a phone consult prior to > dispensing the herbs? > > kb > > On 1/24/07, Bob Linde,AP, Herbalist <boblindeherbalist<boblindeherbalist%40>> > wrote: > > > > I have found acufinder very effective. Also when I have a patient moving > > out of state or a family member out of state, I find an AP from > acufinder, > > call and see if they are a good fit for the patient. > > Bob > > www.acuherbals.com > > > > Angela Pfaffenberger <angela.pf <angela.pf%40comcast.net> < > angela.pf%40comcast.net>> > > wrote: > > There seem to be lots of internet advertising opportunities now-a-days, > > such as listings on a site, such as acufinder. > > > > I wondered if people would be willing to share what has worked for them > - > > or not worked. > > I tried google adwords. It was hard to track if it brought in clients > but > > it's afterall very inexpensive once you actually have a website. > > Angela Pf > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 26, 2007 Report Share Posted January 26, 2007 This exchange really gets to the heart of our professional identity (medical provider vs small businessman). Some would like us to remain lowkey and cash-only and others want to participate in the mainstream medical system with ops to work in hospitals and get paid by insurance. Folks, it really takes both and I cannot figure out why we cannot have some options as well. I think a good question was brought up in the response below about liability. We often overlook this and yet to some degree a person who is selling online or in office bares some responsibility for their prescriptions. I think we get into an unkind area when we fail to see that our professional stake in such an endeavor might reflect poorly upon the rest of the profession. I guess it is easier to condemn this when it comes from someone who is only interested in the business of selling. I can see both sides and then there is also the patient taking their own responsibility to order and take such a medicine. OTC has created some interesting issues over the years and yet it helps to keep prices down and makes things easier to get. The down side to patient limitations though includes the higher prices that are asked for and a much limited availability of product. Great dialogue, no solutions. Mike W. Bowser, L Ac ________________________________ > Chinese Medicine > acukath > Thu, 25 Jan 2007 21:51:58 -0500 > Re: Internet chinese patent herb store > > Love to hear from others on their thoughts... > Bob > www.acuherbals.com > Well, since you ask. . . I must say i was alarmed when i saw your sight. i > don't agree that chin. herbs should be made avail to the general public. i > feel they should only be dispensed by a qualified herbalist. and by that i > mean someone who has graduated from a TCM program in chin. herbs, and has > taken board exams (NCCAOM or equivalent) to show competency in chin herb. i > don't not agree that one should be allowed to prescribe chin herbs with acu > only training, as is the case in my state, NC. > as for selling herbs on-line, you have to practice in a way that is legal, > ethical and comfortable for you. personally, i would not feel comfortable > dispensing chin herbs to joe public without knowing anything about him. i > wonder as an AP if you could be legally liable for malpractice if someone > were harmed by taking herbs purchased at your web store? > i wish mayway would only sell herbs to practitioners, and would not > distribute them to health food stores and catalogue houses, and do not > patronize their company because of this practice. > i have not seen herbal times avail. over the counter, are they aware that > you are selling their products OTC in an on-line store? > likewise, i do not agree with dispensing policosonol or chin. red yeast rice > OTC. you have no idea who's taking it, and whether they should be taking it > without seeing their blood chem. > that's my opinion. i'm sure there are others, like yourself who feel > differently. i feel this practice harms the profession. > kb > On 1/25/07, Bob Linde,AP, Herbalist <boblindeherbalist wrote: > > > > Legally herbs are regulated as foods, so long as no western medicine > > claims are made there is no real regulation. Herbalism is completely > > unregulated....you may have it as part of your scope of practice but that > > does not restrict herbalists from practicing with little or no training. > > Many herbalists practice TCM sans the needles because the language that we > > use allows them to avoid the pitfalls of western medicine claims. > > As to the ethical end of it, it is something that I struggled with. I felt > > that I made clear distinctions as to how to choose each formula and > > mentioned cautions as well as possible side effects. So far internet sales > > have been slow mainly because I don't really focus much energy on promoting > > it yet. So far in the one year I have had it up no one has tried to order > > anything I consider unsafe without a diagnosis...well other than a few folks > > looking for formulas with Ma Huang or bulk Ma Huang....I have both but would > > never sell to the public and have never actually prescribed internally (but > > reserve my rights to use and buy it if I want!) > > Without a doubt it is a difficult issue that has no good answers. At the > > moment the webstore pays for itself and that is about it. Most of the orders > > do come from small towns that I have never heard of that likely have no > > access to APs or herbs so for them its a great service. We are still a very > > small company so I am able to keep close tabs on what goes out to who. So > > far no one is abusing anything. > > Love to hear from others on their thoughts... > > Bob > > www.acuherbals.com > > wrote: > > Kath- > > > > I think this is a great question. I have often pondered selling herbs on > > my own website (which is currently still just a dream), and have wondered > > how I would handle the professional aspects of proper pattern identification > > and prescription when I cannot personally see/hear/smell, etc. the > > prospective " patient " to confirm what they are telling me, and would be > > lacking these sensory clues which often prompt me to ask questions I > > otherwise might not think to ask. I know there are many acupuncturists, and > > even people who are not acupuncturists who sell Chinese herbal formulas > > online, and I don't know how they do it - ethically, legally, and > > professionally. Also, there is the aspect that many herbal manufacturers > > attempt to prevent this sort of sale, and I don't know how those who do sell > > herbal formulas online get around that. If there's anyone on this list who > > does this, I'd like to know your thoughts and experience with it. I know > > this discussion is one potentially > > big can of worms, but I think it is worth talking about. > > > > My father recently was looking for information about Haradas disease > > treatments for my sister, and found a group of acupuncturists online > > operating out of England, who sell pretty potent herbal formulas with the > > only requirement being a health history form to fill out. There is no way to > > call them, yet they say they will modify your formula based on your > > questionnaire. Their disclaimer is that they do not recommend herbal use > > without a personal consultation, but they do not require it. When you buy > > their herbs, they sell 6 months' worth at a time, for several hundreds of > > dollars. I looked at the formula they had for Haradas disease, which > > included many of the herbs I would have thought to use for that condition as > > it is described in medical journals, but those descriptions do not at all > > match my sister's pattern differentiation. It was a good learning experience > > which made my hair stand on end and also prompts my questions here. > > > > > > > > " " <acukath > wrote: > > i looked at your website and noticed you're selling chinese patent herbs > > and > > other products on the web. do you require a phone consult prior to > > dispensing the herbs? > > > > kb > > > > On 1/24/07, Bob Linde,AP, Herbalist <boblindeherbalist > > wrote: > > > > > > I have found acufinder very effective. Also when I have a patient moving > > > out of state or a family member out of state, I find an AP from > > acufinder, > > > call and see if they are a good fit for the patient. > > > Bob > > > www.acuherbals.com > > > > > > Angela Pfaffenberger <angela.pf < > > angela.pf%40comcast.net>> > > > wrote: > > > There seem to be lots of internet advertising opportunities now-a-days, > > > such as listings on a site, such as acufinder. > > > > > > I wondered if people would be willing to share what has worked for them > > - > > > or not worked. > > > I tried google adwords. It was hard to track if it brought in clients > > but > > > it's afterall very inexpensive once you actually have a website. > > > Angela Pf > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 26, 2007 Report Share Posted January 26, 2007 Very interesting dilemma this....many sites are selling directly to the uneducated public. When I asked a person at a large chain store how they were able to advise people which formula was appropriate, the clerk got uncomfortable and pointed at a book....pick yourself... In California, the State Board sent a letter out years ago... The Acupuncture Board has recently learned that some acupuncturists have been prescribing herbs over the telephone or internet...However, before a practitioner can prescribe a treatment or herb, he or she must diagnose the patient’s condition. In evaluating whether a practitioner has performed a proper diagnosis, the Board will look to the standard of care that would be exercised by a practitioner in good standing who is prescribing similar treatments or herbs. If a diagnostic technique is inconsistent with the standard of care for a practitioner to prescribe herbs, the practitioner is subject to discipline for having engaged in unprofessional practice. In traditional Chinese medicine, the diagnostic standard of care is to perform four specific examinations, which involve: a) asking questions; b) visual examination, including tongue diagnosis; c) palpatory examination, which may involve pulse, acupuncture point palpation, and abdominal examination, and d) listening/smelling examination, etc. These four examination components are commonly used in diagnostic procedures to evaluate and diagnose a patient’s condition. Such techniques are not usable when an acupuncturist attempts to diagnose a patient’s condition and prescribe a treatment over the telephone or internet. Accordingly, practitioners who diagnose and prescribe treatments over the telephone or internet may be failing to meet the standard of care and engaging in unprofessional conduct. emphasis added... Stephen Woodley LAc Mike Bowser wrote: I think a good question was broughtup in the response below about liability. We often overlook this and yet to some degree a person who is selling online or in office bares some responsibility for their prescriptions. kb wrote: ...i wonder as an AP if you could be legally liable for malpractice if someone were harmed by taking herbs purchased at your web store? Bob Linde wrote: Legally herbs are regulated as foods, so long as no western medicine claims are made there is no real regulation...So far in the one year I have had it up no one has tried to order anything I consider unsafe without a diagnosis... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 29, 2007 Report Share Posted January 29, 2007 Wow, I wonder how MD boards deal with suggesting/selling vitamins and minerals .....Its certainly an interesting place that we sit....as a AP with a licence we have greater liability than an unlicenced but well trained herbalist. I understand now why some of the better herbalists who had an AP licence allowed it to lapse. Bob www.acuherbals.com steve woodley <learntcm wrote: Very interesting dilemma this....many sites are selling directly to the uneducated public. When I asked a person at a large chain store how they were able to advise people which formula was appropriate, the clerk got uncomfortable and pointed at a book....pick yourself... In California, the State Board sent a letter out years ago... The Acupuncture Board has recently learned that some acupuncturists have been prescribing herbs over the telephone or internet...However, before a practitioner can prescribe a treatment or herb, he or she must diagnose the patient’s condition. In evaluating whether a practitioner has performed a proper diagnosis, the Board will look to the standard of care that would be exercised by a practitioner in good standing who is prescribing similar treatments or herbs. If a diagnostic technique is inconsistent with the standard of care for a practitioner to prescribe herbs, the practitioner is subject to discipline for having engaged in unprofessional practice. In traditional Chinese medicine, the diagnostic standard of care is to perform four specific examinations, which involve: a) asking questions; b) visual examination, including tongue diagnosis; c) palpatory examination, which may involve pulse, acupuncture point palpation, and abdominal examination, and d) listening/smelling examination, etc. These four examination components are commonly used in diagnostic procedures to evaluate and diagnose a patient’s condition. Such techniques are not usable when an acupuncturist attempts to diagnose a patient’s condition and prescribe a treatment over the telephone or internet. Accordingly, practitioners who diagnose and prescribe treatments over the telephone or internet may be failing to meet the standard of care and engaging in unprofessional conduct. emphasis added... Stephen Woodley LAc Mike Bowser wrote: I think a good question was broughtup in the response below about liability. We often overlook this and yet to some degree a person who is selling online or in office bares some responsibility for their prescriptions. kb wrote: ....i wonder as an AP if you could be legally liable for malpractice if someone were harmed by taking herbs purchased at your web store? Bob Linde wrote: Legally herbs are regulated as foods, so long as no western medicine claims are made there is no real regulation...So far in the one year I have had it up no one has tried to order anything I consider unsafe without a diagnosis... Quote Link to comment Share on other sites More sharing options...
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