Partners in practice: practitioners' perceptions of herbal medicine manufacturers revealed through dispensary decisions

The dispensary of professional herbalists and naturopaths, with its stock of herbal products, provides a window into their relationships with both herbal manufacturers and patients. This research aims to examine their decision-making process in relation to dispensary stock. Method: A survey was developed in the Qualtrix platform to gather the perceptions of practitioners of Western herbal medicine in Australia who are responsible for herbal dispensary decisions. Links to the survey were disseminated through major professional bodies and a hard copy was distributed at the NHAA International Conference in 2015. Results: One hundred and sixty-seven surveys were completed by decision-making initial respondents who tended to be in their forties and in practice for over 10 years. Herbal tinctures were ranked by 71% as their most frequently prescribed herbal product, followed by herbal tablets (23%). Eighty-five percent purchased stock from two or more suppliers and/or manufacturers. The range of herbal products (both plant species and preparations) and perceptions of manufacturers ‘standards and practices’ drove decisions about purchases. Clinicians’ textual responses reveal high expectations of manufacturers beyond manufacturing standards, including ethical practices, honesty, sourcing of herbal raw materials, investment in research and customer support. Conclusion: Practitioners rely on manufacturers to provide clinically effective herbal products, to disseminate research summaries and to provide continuing professional education. This gives manufacturers great responsibility and influence. Australian herbalists need to be aware of the importance of access to independent, non-commercial advice regarding all aspects of the clinical encounter.