[00:00:02] Speaker A: Hi, everyone, and welcome to the Nervous Herbalist, a podcast for chinese medicine practitioners who like herbs and want to learn more about their function, their history, and treatment strategies to use in the clinic. Let's get into it.
All right, everybody, welcome back to another episode of the Nervous Herbalist. I am one of your hosts, Travis Kern, here with Travis Cunningham. And we're back to talk with you guys about some more interesting topics in the realm of chinese medicine. So we've got some ideas today. We want to talk a little bit about herbal pharmacy and sort of what it takes to run an herbal pharmacy, and a lot of the considerations when starting up your own shop.
And so we've kind of structured this to just be a casual conversation between Travis and I, mostly around our experience. What was it like for us to actually open this business that we do now, and what was it like? So that's how we're going to structure it for you guys.
[00:01:03] Speaker B: So I thought it would be interesting to start our discussion based upon a question that I was asked a while ago at a tea shop here in Portland, which was, why would you use chinese herbs when you could just use western herbs, herbs that are grown locally, that can be grown. Like, you can be sure of the growth. Why would you use chinese herbs? Like, if I'm somebody who is going to a practitioner and wants to get herbal medicine, why would I ever pick a chinese herbalist over a western medical herbalist? So how would you answer that question?
[00:01:48] Speaker A: Well, I'd have to take a long sip of my tea first. That was at the tea shop, which is what I did, and try to think about how to answer that question in a way that answers the person's honest inquiry and also doesn't wildly alienate us from people who work in our field or in adjacent fields like western medicine. Because the first thing that I want to say about that is chinese medicine and western medicine. Well, let's back up. Chinese herbalism and western herbalism are not two sides of the same coin. They are two different things. Yeah, they both work with plants and ostensibly use plants to help ameliorate human suffering or improve health outcomes. But the inheritance of chinese herbal medicine today far outstrips what's available in the western tradition. And that's not a testament to its superiority or anything intrinsically. It's really a function of who kept the paperwork and what lasted to today. Without doubt, the herbal tradition in the West, I think it's safe to say, was as robust, likely as robust as the chinese tradition.
However, we do not have the collection of literature, of case studies, of doctor reviews, of journals, of the sheer volume of material that has persisted in the chinese tradition and the east asian tradition. It's innumerable comparatively, right?
It would be a different story if western herbalists today were practicing from, say, the collected works of Galen, or practicing the medicine of Ibn Senna to major names in the western tradition. That would be a different story. Because actually, it's not like we don't have these texts. I mean, you can go read the Canada medicine. Ibn Senna wrote this massive treatise that includes all complex formulations, plants, et cetera. But if you visit a western herbalist, that's not what's mean. Don't get me wrong. Some audience person listening has been like, no, I know an Avicenna practitioner. Of course there are direct lineage. Yeah, there are three for sure, right? But on the whole, that's not the experience, right? Most western herbal texts, western herbal practitioners are thinking about herbs through a pharmaceutical lens, right?
They'll use terms like active ingredient, or they'll describe herbs using those biomedical terminology, like, oh, this is anti emetic, right? Like it stops vomiting, or it's anti inflammatory, or it's anti diarrheal, or it's abortive. Like just using terminology from the western tradition, which is not Galen's terminology. It's not Ibn sina's terminology.
And the diagnostic process for using western herbs among most western herbalists is virtually nonexistent, right? It is. You have some bowel problems. You probably need an herb that's demolscent, which means that it is softening and wet. So here, make this tea out of slippery elm bark. It'll help your irritable bowel, right? And the thing is, slippery elm bark is a great herb. If you drink, it's not really about.
[00:05:14] Speaker B: The herbs, is it?
[00:05:15] Speaker A: No, it's not. It's about the diagnostic principles behind it. And it's about the knowledge of how to implement those herbs in a meaningful way. Right? I mean, not to put too fine a point on it, and someone's going to write in angry about this, but western herbalism, writ large, does not treat serious medical conditions, right? No, absolutely it's not. And again, someone's going to be really angry about that.
[00:05:40] Speaker B: And I'm sorry, in most forms of it, it's not very clinical, right?
[00:05:46] Speaker A: I mean, it's supportive therapy, right? It's like, oh, take this elder flower extraction for your immune system, or here's some black cohosh tincture to help with your mood.
Honestly, it lives in the same realm as sort of like lighting scented candles and doing breathing exercises. All of these things are helpful. Like, great. Yeah. You should have a robust system of self care that keeps you grounded, keeps you centered, reduces stress. I'm not saying it's not important. I'm just saying that western herbalism does not have the tradition, the extant tradition. It's not that it didn't exist before. It's just that people don't use it this way now.
[00:06:26] Speaker B: It's not been handed down in the.
[00:06:28] Speaker A: Same way it hasn't. Yeah, I mean, it'd be way more interesting, actually, if there, and I mean, I know there are some western herbal schools. In fact, I'm even thinking one. It's literally called the school of Galen. Right? And they use some humoral theory, and they do a little bit galen oriented material, but it's nothing like the robust clinical diagnostic parameters that exist in chinese herbal medicine. It's a different game.
[00:06:54] Speaker B: Well, and really, what brings a medicine to life is the practice of it. And you have to be able to witness people practicing it. You have to be able to practice it yourself and get it wrong many times, and then figure out what can work for this person and the majority. Just because herbalism isn't really a thing in most places, at least in our.
[00:07:20] Speaker A: Country.
[00:07:23] Speaker B: We don't have western herbal hospitals. That's not a thing. No, but there are hospitals where people exclusively practice chinese herbal medicine. And not just in China, but all over, like, you know, India. There's hospitals that practice ayurvedic medicine. Tibet, there's hospitals that practice tibetan medicine. All of these systems have been handed down, but they're also actively practiced in serious medical conditions that are happening today.
[00:07:59] Speaker A: All of them. Not in some backdoor way, right?
[00:08:02] Speaker B: No.
[00:08:03] Speaker A: When Travis says chinese herbal hospital, he doesn't mean that metaphorically or suggestively. I mean, Travis and I, we did an externship in Nanjing in a 16 story building, like a hospital building that was 16 stories high, full of doctors doing exclusively chinese herbal medicine. Like a line of people sitting and not for help me with my immune system. Maybe I won't get the sniffles right. We're talking about people with Crohn's, people with ulcerative colitis, people with chronic insomnia, people with vomiting disorders, people with horrible infections, people with skin problems, boils, pustules, pus infect. I mean, it's just. Yeah, it's stuff that, for those of you out there listening, who are feeling a little triggered right now, again, I apologize. I don't mean to suggest that going to a health food store and getting your tincture of whatever is a bad thing. It's not a bad thing. It's just that it's not the same thing as using herbs to treat significant medical problems. And the only reason that the distinction is important is because a lot of times people will assume that all of the herbal approaches are the same with the same level of consistency, and that.
[00:09:15] Speaker B: They can only be done well and be helpful.
[00:09:19] Speaker A: Right. Oh, that's a great point.
[00:09:20] Speaker B: That's another one.
[00:09:21] Speaker A: The number of people who live and occupy the natural medicine space who are under the impression that the natural world is intrinsically wholesome, supportive, benevolent.
Well, in worst case scenario, it's benign, and in the best case scenario, it's benevolent. That's a dominant narrative. Right. Because it comes from the earth. It's good. Yeah.
[00:09:42] Speaker B: It's benign and benevolent. Yeah.
[00:09:44] Speaker A: And that is ludicrous.
[00:09:46] Speaker B: That's just crazy.
[00:09:46] Speaker A: It's ludicrous. Like, how many herbs do we have in the pharmacy that we could concoct poisons to kill people with? It's not complicated. Everyone knows if you eat the wrong mushroom, you could drop down dead. People know all about deadly night shade poisoning. I mean, it's weird, on the one hand, to assume, though, people know that there are poisons that exist, but that nature is benevolent. I'm like, are you sure? If you're walking on a beauty, you're having an existentially joyous moment in a Pacific northwest forest, and you're meandering up at the border between Washington and Canada, and you cross into this beautiful glen, and then there's a bear, a grizzly bear, who you've disturbed, who murders you.
The bear does not care that you were just one with the goddess in that moment. Right. Like, you're just going to get killed because the bear is an amoral character. It's a bear. It's what bears do. And this applies to plants, this applies to natural medicine. This applies to everything.
If it's significant enough to help you, it's significant enough to hurt you, right? That is the reality. Right.
[00:10:52] Speaker B: I think application is the key.
We have lots of developed theory that's developed over the course of a few thousand years, right. In chinese medicine. So there's an advantage there over, I would say, what's commonly taught in, like, a six month western herbal program for a few hours a week.
[00:11:16] Speaker A: The other thing, too, is there's also some practical realities as well, which, like you and I, have a license to practice chinese medicine awarded to us by the state of Oregon. And that comes with a scope of practice. And that professional legitimacy also gives us access to things like malpractice insurance and insurance coverage in general. And it creates these systems that allow us to practice medicine which everyone who's being honest about it knows that medicine carries a lot of intrinsic risk, right. And it carries the risk to be wrong, and it carries the risk to harm people, right? Certainly not intentionally, but that is a risk. And so because we are a recognized profession who can carry these added protections to cover us in the event that something goes wrong, we're able to, I mean, I'm going to say take risk, but I don't mean working outside of our scope. I just mean we're able to deal with serious problems, right? But if you are a kitchen herbalist who even studied at the school of Galen and making beautiful tinctured medicine from flowers and herbs and stuff from your garden, you don't have that kind of protection, right? So are you really going to take on the responsibility to say, hey, I can help you overcome your chronic anxiety. I can help your body remember how to sleep better.
I can give you herbs that will help stop you having 30 bowel movements a day that are bleeding and painful. Are you going to do that? Or are you going to say, like, oh, here's a tincture to help you sleep, but if it's serious, just go to the emergency room, right?
And when that's the move, oh, if it's serious, just go to the emergency room.
I'm not sure how much investment you have in the power of the thing that you're doing, right. This is a Leo Ming quote. You are unfamiliar. Leo Ming, a very famous taoist practitioner in the Bay Area in Berkeley, founding dean of five branches college down there, passed away in 2014. Fascinating man. Lots of recordings of his work available at the Da Yuan Circle website. But he was a provocateur, right? I mean, let's be honest, Ming liked to say stuff to rile people up, right, and see how they would respond. But he would stand in front of a room of chinese medicine practitioners and basically prod them to point out that they didn't really believe that their own medicine was real, right. That if it got serious, they'd send someone to the, quote, real doctors, right?
And it's a weird thing to talk about because part of that sounds a little bit like bravado, right? Like, oh, you shouldn't use the western doctors because our medicine is the best.
And I think you could take it that way. I think you can make it bad in that way. But I don't think that's really the case. Right. I think the difference is that understanding what we can and can't do, but really understanding that. Right. If you get run over by a truck and your arm is ripped off or whatever, please do not go see an acupuncturist for that. Right. I mean, we're not suited for that. You need to go to the emergency department. They're going to sew your arm back on, and they're amazing at that. Biomeds are amazing at cutting things out and putting them back. Right. They're very, very good at that. But after your arm's been sewn back on, the chronic discomfort, pain and lack of use that you have may not be well suited by or two more surgeries, for example, or pharmaceutical interventions that are a bit inexact. That's where we come in. Right. Our medicine is super well suited to chronic problems. We're also suited to some emergency problems for sure, like infections and topical issues and stuff like that. We're absolutely great at that. So we can, as professionals in this field with a long standing history of the medicine, with thousands of years of diagnostic theory, we can take that quote unquote risk to treat that patient. The western herbalists don't. They have neither the training, they don't have a deep understanding of their medicine to actually achieve in that way. And they're frankly at much higher risk in order to do it. So of course they're not going to. Right? Yeah.
All that to say, I know that's going to sound like we're hating hard on western herbs. And I guess on some level maybe I am.
[00:15:25] Speaker B: But again, it's not western herbs, it's more the practice of western herbalism. And it's just like there isn't that many places you can go for a clinical experience like you would have if you came to one of our clinics with a western herbalist. I'm not saying they're not out there.
There's some really cool work that's being done. Gosh, I can't remember the name of their company. I think it's evolutionary herbalism or something. They're up in northern Washington or something like that. And when I listen to those people talk about western herbal practice, you can tell that they're clinicians. Like they see patients and they use them for real.
Yeah, but that isn't the majority of the people out there.
[00:16:13] Speaker A: No.
[00:16:16] Speaker B: And even when you combine, we bring into the scope of botanical, like western botanical medicine.
Let's say, in the hands of a naturopath. Right. Some of us in our field are naturopaths as well as chinese medicine practitioners.
But the botanical medicine spectrum of things doesn't have the same sophistication of combination alchemy. Doing this with this equals this.
[00:16:47] Speaker A: Yeah, that's an important distinction.
[00:16:49] Speaker B: To some degree. What we are isn't really herbalists, in a sense, we're more like formulaists or alchemists.
[00:17:00] Speaker A: Yeah.
[00:17:00] Speaker B: We don't just use plants.
I can't remember who said this, but it was a famous teacher in our field, somebody who was saying that there's the herbalist who will go in and hunt in the jungle for that one herb in the most dangerous part of the jungle that will cure the disease for the person in the village. And then there's the formulaist who's like, I'm not going into that jungle, right. I'm going to combine this, this, and this to do the same thing and build any need from 50 different ingredients that I can pull from at will with the same 50 things forever. I don't need all this other stuff. So there's this intrinsic component of alchemy theory and application that traditional chinese herbal medicine provides. That's lacking, I would say, in most of the western herbalist approaches.
[00:18:04] Speaker A: Yeah, the combination piece is huge. Right. Because a lot of people in the western tradition are using single herbs. Right, right. Here, take a quick tincture of this or a tea of that, and maybe there's a couple of combo things, like here's a sleepy time tea, or here's anxiety tea or something. But a lot of times, if you look at the ingredients of those herbs, all the herbs will be of the same type, for example. So, like, I'm going to make a sleepy tea with six different sedative herbs, right?
[00:18:34] Speaker B: Yeah, exactly.
[00:18:35] Speaker A: If you look at a chinese medicine formula for insomnia, for example, you're not going to find a big pile of sedative herbs. No. Right. In fact, depending on the type of insomnia you have, you might have no sedative herbs.
[00:18:47] Speaker B: That's more common for.
[00:18:49] Speaker A: Yeah, exactly. Because my goal, actually was not to sedate you at the moment of sleep, but in fact, to provide you with a complex formula to deal with the underlying pattern that's making your body and mind resist sleep. In fact, in many cases, you're going to take this formula during the day. Right. It's not sedative. Right. So one of the things that will happen is you'll see combinations of things in the western tradition, but they'll be, in my opinion, unbalanced formulas, right. They'll be very heavy in one direction or another, thinking always that more is better, right. As opposed to thinking through the alchemy of the combination of things and how we create a more balanced intervention that, in fact, is actually more effective than just piling on a big jumble of sedatives. In this case, I think that distinction is really important, because, again, even if you're combining single tinctures in the western tradition, I mean, what's happening there? What's the goal? What's the tradition of that? Right? And this is where you're right. The formulation of things is really what chinese herbalism is about.
Of course, you learn all your single herbs, but when you really get into it, it's about formulas, and then it's about how the flavors of the ingredients in those formulas act on the body. And then that allows you to do the substitution thing that you were talking about, right? Because now, look at our pharmacy. We just did inventory for the end of the year, and between the granules and the bulk, we've got like over 850 skus.
So in bulk herbs, we've got 420 something, 450 something herbs. I mean, that's unheard of in the history of medicine in general, to have access to all of that.
It's wild, right?
And if you were a rural herbalist, for virtually all of chinese medicine's history, you only had access to what was in your biome, what grew in the zone. Maybe if you worked for wealthy families, or certainly if you worked for the emperor, you'd have much larger reach, right, because you could buy stuff from merchants and whatever, but it meant that people had to make do with what they had. And that's why we have such a robust tradition around powder, right? And that's another thing that's often missing in the western tradition is the ability to take an herb that has an action when it's cut and dried, and a different action when it's been boiled in licorice first, and a different action if it's been steamed with salt, and a different action if it's been cooked with these other three herbs and then dried again. So that is not just because classical chinese practitioners were trying to be clever, right? It was a way to get an herb to do a thing that they needed done based on what they had around.
But because it was recorded and because it was tested, because it was reviewed by very famous and often wealthier doctors or doctors who worked for wealthy families, we now have analysis of that and so then powder shifts from just being, like, a thing that a rural doctor is trying to use to make something work into a system that says, hey, if you need this herb to move more quickly in the system, you can fry it in wine. If you need this herb to be a little bit less yang and a little bit less chi oriented, you can bake it. Right? If you need it to be less wet, you can bake it. Right? If you want it to work in the middle Zhao, you can cook it with earth or bran, because those things are going to bring it there. So then the system becomes organized in a way that you can now cross apply it to any number of things. And this is an important factor for all of you out there who are herbalists and who are aspiring herbalists, is that supply is a big question.
How long will we have access to the herbs in the way that we have access to them now in the west, right.
We all know the world is changing from a climate point of view and a geopolitical point of view. And there's a huge amount of uncertainty in the world that we live in. And if we're not careful, because we only relied on.
Well, I'm going to say it this way. We only relied on the words in a book, which is to say, well, I have to give this person Shao Chaiutang. And Shao Chaiutang has Chaihu Ban Sha Huang Qin. If I can't get Chaihu, I guess I can't write Shao Chaiutang. What you've done is you've given over the power of what Shao Chaiutang is to the words chaihu, right? As opposed to understanding what chaihu is and what its nature and flavor is and how it moves, so that if you can't get chaihu, you can use something else. Now, I picked chaihu, which is maybe the worst example or one of the worst, because it's a very particular herb, a little bit like mop Wang's hard to find substitute for. But nonetheless, it's possible, right? There are people writing formulas that have the same actions as other formulas. And if you put the list of ingredients side by side, and I said, oh, here's Xiao Chaiutang, and then here's this other formula that has virtually none of the ingredients in the original Shao chai utang, and you're like, there's no way that's doing the same thing. But upon deeper analysis, you can see, actually, it is because the way these natures and flavors work together in harmony facilitates the same harmonizing effect on Shaoyan. Right.
That is the deep knowledge. Right. And that's the kind of knowledge that all of us, myself included, I know you've been working on this for years, are really trying to internalize more. And for me, it's because I have a deep concern about supply. I have a deep concern about it. It's expensive. Already the demand is increasing. Politics is a not insignificant factor here. The tensions between the US and China and China and other parts of the world are not getting any easier. And so what happens in three, four, five years when there's a political fallout and all of a sudden, all trade between China and the US stops overnight? What happens? Oh, shit. Now we're in a.
You know, a lot of people are talking about growing stuff domestically now. Right? So.
[00:25:02] Speaker B: So domestic growth. I want to get there in a minute. But before we move on from the subject of powder, I'm wondering if you can tell the story of when we were in China. You were observing with a female doctor with a super big lens. She looked down the people's throats and the gene. Gene prep. Do you remember?
[00:25:25] Speaker A: No. Do you remember that? Tell me about it. I remember the doctor because she had experience.
[00:25:29] Speaker B: I just remembered this story.
[00:25:31] Speaker A: I just remember that doctor is frozen in my mind. For all of you who've ever seen the old bugs bunny cartoons where the doctor has a headband on and there's like a big circle on the top of the head. And I remember as a kid being like, what is that for? Why is the doctor wearing that? Never seen it. Then we go into this treatment room, and here's this doctor. She was in her 80s. Yeah, she's older, in her 80s. She's like an ent specialist.
[00:25:55] Speaker B: Hall of fame. The hall of Fame section of the hospital.
[00:25:58] Speaker A: Yeah, literally her pictures on the wall, right? So we're getting to observe with her, which is super cool, and then all of a sudden, the first patient walks in and she's going to look in their throat and she flips. Imagine that circle is, like, up on her forehead. It turns out it's not a circle. It's a concave mirror with a hole in the middle, right? So it's like countersunk. With a hole in the middle. And she flips it down so that the hole is right over her eye. And the concavity of the mirror is therefore pulling light into her eye so that she can see better into the person's throat. So it's like a super analog tool to be able to see into the person's throat. And I thought, man, there are not very many people left alive who even know what that thing is, much less, like, how to use it effectively. Was she using a digital scope or no eye mirror thing? Right. I don't even know what it's called. Super cool. But I don't remember. The genie gene remind me of my own life. Yeah.
[00:26:56] Speaker B: So, genie Gene, for those of you who don't remember what that is, this chicken gizzard lining. So it's the lining from the chicken's gizzard. It's a salty.
I think it's either neutral or warm flavor, maybe. But it's used a lot for treating stones.
[00:27:13] Speaker A: Right.
[00:27:13] Speaker B: Like, we learn it. Anything with gin in the name. Most things with gin in the name are good for treating stones anyway, so that's kind of like what you learn about it in school. But she ended up writing it for a patient in a big formula. Like, there were many other ingredients, but she honey prepared it. Do you remember that?
[00:27:33] Speaker A: Yeah. Honey fried genie Gene.
[00:27:35] Speaker B: And do you remember asking her about that?
[00:27:40] Speaker A: Okay, see, I wasn't even here.
[00:27:42] Speaker B: I just remember the story because we talked about it later that day. But you asked her why she honey prepared it, right? And she just said, well, it's for the metal jow. It takes the function more into the metal jow. And she honey prepared something else in the formula, too. It was, like, weird, like Euren or something like that. It was honey prepared, and she laughed when you asked her that. And she said that the chinese students would never ask me that question.
And you asked her, is that because they would already know the answer? And she laughed, and she said, no, they would just never think to ask.
[00:28:23] Speaker A: That was a little bit our experience in China, though, right? Yeah. A lot of the chinese students just.
[00:28:27] Speaker B: Kind of, like, rolled with it and not asking questions. It's cultural to save face. There's a narrative about that.
[00:28:36] Speaker A: Here we are, like, these loud Americans just being like, why'd you do that? Right? Why'd you do that? Why'd you do that? Could you explain it to, like, I don't understand.
[00:28:45] Speaker B: And what's funny about this particular doctor is we were on separate shifts, Travis and myself, and I was on her shift the following day. And when I got into the shift, we're all with translators, right?
I don't know very much Chinese at all. I'd be able to understand, like, 2% of what was going on without a translator. So we get in there, and she sees a few patients, and then there's a little bit of a break. And she just kind of starts laughing and then kind of, like, muttering to the students in Chinese. And I lean over to the translator and I'm like, what's going on? Why is she laughing? And the translator said, oh, she's laughing about this american student who was talking about the mattresses and how the bed mattresses were too uncomfortable and he had to go and buy one to get more comfortable.
[00:29:36] Speaker A: That was me. That was me.
[00:29:37] Speaker B: And of course, I know who it was.
[00:29:39] Speaker A: Yeah.
I mean, to be fair, they were having us sleep on box springs.
[00:29:44] Speaker B: Yes.
[00:29:44] Speaker A: Right? So no judgment to the cultural standards except to say that I don't regularly sleep on a box spring. I mean, literally just a box spring, you guys. I don't mean like a mattress on a box spring.
[00:29:58] Speaker B: I mean, like, yeah, the springs.
[00:29:59] Speaker A: Here's a box spring. And we put some sheets on it and they were like, oh, here's your bed. And we were super sick. We all got sick the first week.
[00:30:09] Speaker B: We all got sick because we're in Nanjing and it's smoke city, so everybody gets sick.
[00:30:15] Speaker A: It was really bad. I've never been that sick, actually. And fortunately, we were there at a chinese medicine school. So of course we all went and got herbs and whatever, but I couldn't sleep normally. If I get sick like that, I just sleep it off, right? Drink a bunch of water and take some herbs and go to bed. But I literally could not get comfortable, so I had to go to Ikea. I remember this. I was like, all right, where can I go to get something soft to put on this bed? So there's an Ikea in Nanjing because Nanjing is a massive city of 13 and a half million people. So go to Ikea. And I'm on the subway to get to Ikea. And this is before COVID Way before COVID So as Americans, we did not have practice wearing masks, like respiratory masks. So I'm just on the subway looking like death, right? Sweating and just like, look pale. Get to Ikea, buy these mattress things. And one of our friends had asked us to buy a mattress, too, like a cover mattress cover. So they rolled up tight so they're small, but they weigh a ton, right? And so I'm trying to figure out how to carry three of these fuckers with me onto the subway. So I've got two on one shoulder and one on another shoulder. And our friend Carrie was with us and she's, like, helping me balance. And I'm standing on the subway and now I'm even more exhausted because I'm carrying all this weight. I've gone all the way across the city. I've gone all through Ikea, and he'sick, and I'm so sick, and so I'm just sweating. I look like a nightmare. Like, I look like a walking pile of disease. And all of these poor chinese people in the subway car are, like, staring up at me because I'm very tall, so I'm, like, way taller than they're all staring up at me, like, what's happening? And you can see them kind of pushing to the edge of the subway car, but it's packed. There is no place for them to go. And all the ones immediately around me, you could tell were just like, why do you not have a mask on? Why are you out right now? Because Chinese people, I guess probably since bird flu and Sars and stuff, they wear masks in a heartbeat.
[00:32:08] Speaker B: Well, even for the smog. Some of them.
[00:32:10] Speaker A: And the smog. Exactly. So anyway, we got the thing set up, put it on my box spring. I was able to sleep, plus the chinese herbs, and recovered. But that then became a defining story of our months in China because I don't know how I would have made it without it. Right. You just slept on the box ring the whole time, didn't you?
[00:32:27] Speaker B: I did, yeah.
[00:32:27] Speaker A: That was hardcore.
[00:32:28] Speaker B: Somehow I pushed through.
Yeah, it was quite a thing. All right, so I want to pivot back, though, to domestic production. So I wanted him to tell that story because it's one way that powder is used in our medicine, and it's particular, really, to that practitioner. For her honey, preparing the gene. A gene helped to drive the function more into the middle jow and helped to encourage that part of the body to do its function better.
She's not unique. I'm sure there are other people who do that, but that's not something that I remember learning about in school, I don't really know. And as chinese doctors and our medicine get more and more experience, there tends to be more personal quirks that arise in the practice. And I think that that's also kind of unique about our prescription style and how our medicine works as a whole.
[00:33:32] Speaker A: Yeah, I think so. And it's interesting that the powder piece is a transition over to domestic production, because actually, powder is one of the hiccups with domestic production. Right. So the short version of this story is that there's a lot of concern, as we mentioned, about climate issues, contamination issues, geopolitical issues that make people think, like, well, maybe we should grow more of these herbs ourselves, and America could actually be the US could actually be a exporter back to China, to Japan, Korea, Australia, Europe, places where people use a lot of these herbs. They could be coming from the US, right, instead of from China, where there are all these greater concerns in terms of global trade and what have you. And there are a lot of things that come up there. And the very simplest and first one is that chinese herbs just aren't grown in any old place in China, right. They're grown in specific regions and traditional growing areas. And they subscribe to the same notion of, well, in English, we use the french word terroir, like in wine and coffee and stuff like that. You'll hear people talk about the terroir, like the quality of the land impacts what's grown there. In Chinese, they call that dao Di. And it's the same idea, though, right? The reason we're growing this weight in this region is because the soil and the temperature and the sun and the wind and all that stuff create for the most potent wuita, right? You could grow it in other places, but the best wueta comes from X place, right? So the first question is like, well, does the US contain the necessary diversity of biomes and habitats that we could grow any reasonable number of chinese herbs in the US? The fun fact is the US is enormous, and we have a hugely diverse geographic area. So the short answer is, yes, we can grow basically everything you can grow in China, you can grow in the US somewhere. Right? But as we mentioned, we don't just write one herb formulas, right? We work with 6810, a dozen herbs. And so that means that the sheer number of individual plants that you would need to grow, like different species of plants in order to create enough of a supply to reasonably replace any of the chinese supply is challenging. It would take a lot of land and coordination, et cetera. Right. The other major piece is that powder is a factor for a lot of chinese herbs. I mean, not most. In fact, I would say the majority of chinese herbs are just cut and dried. Right.
They're not prepared in any particular way. Right. But even small things, like we're going to grow the peony roots. Do the peony roots need to be peeled or not before we dry them? Right. That's a knowledge question. Maybe a powder question, maybe it's just a farming agricultural question, but that information exists. Of course, we're doing it in China on massive scale, but it doesn't exist in English, at least. It's not readily available. There isn't like a handy how to grow chinese herbs translated text from China. And a lot of really amazing people have been working on this question for a long time. Peg Schaefer with petaluma herb farm. They were doing work in the late ninety s and early 2000s, like, frankly, kind of figuring this stuff out on their own. They had like, here's some dongwei seeds, like, let's grow some dongue, see what happens. Which is unbelievably dedicated work on their part. But also, I will say, was a lot of reinventing the wheel. It's not like people didn't know how to grow dongwei. It's just that it was the. How would you find that out? You, like, call China, just dial a random number and. Excuse me, I'm looking for some information about growing dongwei. Right. I mean, it just wasn't an easy question to answer. So pioneering and dedicated people spent a lot of time trying to figure it out. And here we are now in the modern era where we could ease it. I mean, when we were in China again, we took a tour of the herb growing farm for the university, where they have an entire department, a whole degree track solely focused on pharmacy and growing chinese and assessment. Like, how do you determine it as potent and storage and quality and basically all of the behind the scenes stuff that's necessary for all of us to be able to do the clinical work. There's an entire degree program that people can specialize in nudging. So again, it's not like the knowledge doesn't exist. It's just a mandarin, right. And you got to go get it from these other places. So there's a diversity problem, a terroir problem, a knowledge problem. And then the biggest problem, in my opinion, from all of it is that even once you solve for all of those first three, it's expensive. Yes, it's expensive. Right? Because labor is different in the US. You can't just be low ball paying people to do work. Land is expensive. Insurance is expensive. Distribution is expensive.
[00:38:19] Speaker B: So give people an example of an experience like where you've been approached because we've been approached by local us growth.
[00:38:27] Speaker A: Yeah. And even local here in local for sure. So we buy all of our herbs from importers, right? But the bulk herbs are coming from importers. We mostly buy from spring wind and new herb because we like their quality and their pricing, et cetera. So we were buying a pound of gigung, which is what's balloon flour, platycodone. I was like, what is that in English? So buy a pound of gigung from new herbs, organic jiagung from new herbs for probably like 14, $15 a pound. Right. It ranges a little bit. And that organic certification is a California organic certification because obviously it's being grown in China. So there's like a little bit of question about how organic it is. So those importers are importing huge amounts of herb, then they're paying for third party testing to test those herbs for heavy metals and contaminants. Right. So there's added costs even once they're here. But nonetheless, when I go to buy it, I'm buying it for $15 a pound. Right. I got a guy growing jagung here just outside of Portland, and in order for him to make money on the sale, he's got to sell it to me for $44 a pound. Yeah, $44 a pound. I mean, it's more than three times the cost.
[00:39:44] Speaker B: Yeah.
[00:39:44] Speaker A: Right.
[00:39:46] Speaker B: You guys are clinicians. If you try to prescribe herbs, how much do people complain about the cost of herbs?
[00:39:52] Speaker A: Exactly.
[00:39:53] Speaker B: Everybody complains about the cost of herbs.
[00:39:54] Speaker A: Imagine now that if you wanted to do it, you'd have to do it at three times the price you already sell it at. Right. We hear all the time from clinicians, people who work in our clinic, our residents, people we talk to on the phone, people calling about this show, like concerns about cost. Right. And to the point that we've watched practitioners reduce their dosage, in my opinion, I think in both of our opinions, to the detriment of patient outcomes because of the concern about cost. Right. So the patient needs to take these granules at 16 grams a day. In fact, they really need to take it at 24 grams a day. And so we're going to. Too expensive at 24. So let's try and get away with 16 and doesn't really work great at 16. And the patient's kind of complaining about the cost anyway. So we'll pull it back to ten or nine.
[00:40:38] Speaker B: Right.
[00:40:39] Speaker A: And now nothing's happening. Right. And the patient still burned the money. Right. They already spent the money and they didn't get anything out of it. Right. But all that to say, cost is a major factor. Yes. Right. And so if you could somehow convince a bunch of growers to grow chinese herbs, if you got your hands on the most amazing growing manual on the planet, if you built regional powder facilities to process, package and distribute herbs. Right. Even if you could do all of that and the price still came in at three times the cost of imported from China. Can't do it. Right? Can't do it. And if we stopped having access to the herbs from China. I still can't do it because it's too.
[00:41:25] Speaker B: People couldn't afford it.
[00:41:26] Speaker A: They can't buy it.
[00:41:27] Speaker B: So we wouldn't be able to move it.
[00:41:30] Speaker A: No. And there's this notion, know, I just talked to a guy the other day who called us. He was doing some research for OSU, the Oregon State University, and he's at the very beginning of his research project. But he was asking about whether or not I thought that the improvements in quality could outstrip the increase in price. Which is to say, these are all the certified organic, artisanally grown herbs that are part of permaculture emplacement. Sure. I mean, just pick up like he was checking all the boxes.
[00:42:05] Speaker B: The sun on a pyramid, oh, my. Shine through the light of every possible.
[00:42:10] Speaker A: Quote unquote, good thing you could think of. He's checking this box, right? And so he's like, okay, if the herbs did all of this, do you think people would be able to absorb the price? And I was like, no.
Definitively no. Right. Firstly, there's a surprisingly small, or maybe not that surprisingly small demographic of people who actually always buy, always spend three or four times the amount of money they needed to spend on something because it's organic. There's actually not that many people out there who are doing that all the time. They'll do it selectively. Right. Oh, I always buy organic apples, but not organic avocados because you throw the peel away. Anyway, people are hustling because it's too expensive.
[00:42:51] Speaker B: Food costs, especially last couple of years, have gone so far up.
[00:42:55] Speaker A: Unbelievable. Right? And what we have observed, too, is that people care about those factors to a point. Yes. Right. And if you tell someone this herb definitely has poison in it, they won't buy it.
[00:43:10] Speaker B: Right.
[00:43:10] Speaker A: But if you say they're like, this is a conventional herb, but it comes from an importer that we trust because they have relationships with their growers to provide us with a good quality herb that hasn't been tested and it could have pesticides on it, but I don't know. Right. As long as the price is right, people will buy it.
[00:43:28] Speaker B: Right. Well, even if they're like, let's say, though, that the organic one isn't available anymore, it's like, well, I really need. The thing that I think of is.
[00:43:38] Speaker A: Chenpi, when you're talking about this Chen.
[00:43:40] Speaker B: Pee and dods out, right? Like, oh, well, the organic one isn't in stock, and as it turns out, it hasn't been in stock for six months. So there's no way. You can expect an herbal pharmacy to hold Dodzile for their dodso to keep for six months without any new dodzile coming in.
[00:44:00] Speaker A: Right.
[00:44:01] Speaker B: So the organic stuff gets used and then you have two options. You can either be out of stock or you can get the more conventional one, which is still given by a reasonable source that reputable companies. Reputable companies.
[00:44:17] Speaker A: We're not just like buying it from Amazon.
[00:44:19] Speaker B: Right?
[00:44:19] Speaker A: Yeah.
[00:44:20] Speaker B: So that's the kind of decision you have to make as a pharmacy. And of the pharmacy people that we know, and we know a lot of people, everyone chooses to buy the conventional one. I haven't seen one case of a pharmacy that will make the other choice. No, we're going to stay out of stock of this herb for six months because we can't get the organic one. Nobody does that.
[00:44:45] Speaker A: No. And if you're the kind of person who thinks that it is important for everything to always be certified organic, then you need to quiz your pharmacies that you work with in great detail. And don't take a lack of explanation as an assumption that it is organic. Right. Because I guarantee you that we know, we track herbs all the time, that some herbs will go out of stock in the market. Like right now, I can't find good quality Mutong anywhere in bulk. Can't find it. New herbs, doesn't have it. Springwood doesn't have it. Plum flower doesn't have it. Right. Mutong is.
Can't. You can't find it. So I could, there are places I can find Mu tong. Right. I can go to, like dragon herbs. I can go to the asian markets in Portland and buy Mu Tong. But I don't know anything about that. Right, right. But we still have some. At some point I'm going to run out and then we're going to be in a bind. But we either have to tell people, hey, man, we don't have any mutong. The good quality stuff's not in stock. Or I'm going to go buy the dusty, less impressive stuff. Right. And just tell people like, yeah, this is super conventional Mutong. We have it. But it's conventional thing is that people will go, oh, well, okay, I'll go to this other pharmacy. They have mutong. You need to double check and make sure that's not the same dusty Mutong that I've got. Right. Because if I can't get it, unless those people had some insane stock of Mutong, they probably don't have much left either. Right. So as a provider. If you're very concerned about this, and I will tell you that if you try to track down the quality for every individual herb, for every formula, every time, for every patient, you will go crazy. Right? Yeah. The thing that you have to do is you find a pharmacy, learn about those people, understand what their principles are, and pass your trust to them, because those people will have done the same thing through a whole series of operations where we pass our trust to Andy Ellis at spring Wind. Because I know that Andy cares a whole lot about this stuff and his reputation and his company is predicated on that level of excellence. So then when Andy works with his farmers, he's passing on. So you've passed your trust to us as the pharmacy. We've passed the trust to the importer. The importers pass the trust to the farmer. Right. Because we're all holding everyone else's trust.
We can feel good that when Andy tells me that this herb is fine, I don't have to think about it, right. I don't have to be like, oh, Andy, could you send me the detailed test? Could I see the exact particulate matter of what happened in this thing? Because I trust Andy, right. This trust was not given lightly, and it's not given randomly. It's given with research and with thought. But if you try to beat back the devil in every possible place that it can arise. Right. Like, could there possibly be a pesticide on my dots out, right. That's maddening, man. It's maddening. Right.
Check with your suppliers. Check with the people who put these herbs together and work with people whose values and whose systems you jive with. Right. And ask hitting questions. And if people don't have answers to them or they're not being honest with you, that tells you a lot.
[00:48:10] Speaker B: Right.
[00:48:10] Speaker A: Then you can decide what to do from there.
I want there to be more domestic production.
[00:48:16] Speaker B: Right. I would love that too.
It would be great. But as you can tell from the things that we brought up here today, there's some major barriers for large scale domestic production to take off.
I want to bring it back to the first question, which was the comparison between chinese herbal medicine and western herbalism. Right. And specifically the aspect of that where the way that the question was asked is the focus of the question is really on chinese herbs versus western herbs. Right. And what we did is we kind of said, well, it's not really about the herbs. It's about the practice. It's about the application.
It's about the science, the differentiation, and the lived experience of applying the medicine in real serious clinical situations time and time again, refining that skill and then handing that down in some way, shape, or form through training throughout the ages.
So when people think that it's about the herbs.
So then the question I'm coming to, I guess, is, could we do chinese herbal medicine with western herbs?
[00:49:38] Speaker A: I mean, for sure.
[00:49:39] Speaker B: Yeah.
[00:49:40] Speaker A: Without doubt. I think the piece that's missing there is the ability to analyze the western herb in chinese medicine terms.
[00:49:49] Speaker B: Exactly.
[00:49:50] Speaker A: Which people have done.
[00:49:51] Speaker B: People have done not well. But like we've discussed before, it has not been done well, and it's not been done well because the people who do the analysis are usually western herbalists. They're not using the herbs from a chinese medicine perspective. So you can classify an herb, for example, with three different natures. Oh, it could be cool or neutral or warm, and it could be sour or bitter or salty. And some of them are more salty, and some of them are more sour.
[00:50:26] Speaker A: Not useful.
[00:50:27] Speaker B: And for us, that is not useful.
[00:50:30] Speaker A: That's not useful. Not accurate.
[00:50:32] Speaker B: Not accurate.
[00:50:34] Speaker A: There are a handful of plants that exist, like waitsa, that have complex and interesting flavors. But even waitza, what do we use waitsa for?
[00:50:43] Speaker B: Like, we use it for the sour flavor.
[00:50:45] Speaker A: Exactly.
[00:50:45] Speaker B: Nine times out of ten, that's what we're using that for.
[00:50:47] Speaker A: Yeah. I mean, the fact that is waitza, does it actually have any salty flavor?
[00:50:52] Speaker B: Right.
[00:50:53] Speaker A: Waits is sour. Right. The seeds are a little bit peppery, but the fruit itself is sour. Sour. So I think that you're right. Could we use western nerves to do it? 100%? There's no reason we couldn't. Right. The reason we don't is because we have all of these other ones that we already know about that have already been classified. And by the way, it's important to note for the audience, not all herbals agree about the nature and flavor of an herb. Sure. However, the variation is not extreme. So you're not going to have one herbal say that an herb is hot and another one say that it's cold.
[00:51:30] Speaker B: Right. In the same medicine.
[00:51:32] Speaker A: That's what I mean. Yeah. So if I wrote a chinese herb book and you wrote a chinese herb book and we were categorizing the single herbs, maybe you call an X herb cool, and I call it neutral. Right. Because they're, like, side by side. Right. But you're not going to call it hot, and I'm going to call it very cold. Right. I mean, not unless we're both idiots or something. Right. That's not what's going to happen. But it could be done with western herbs. I think it's just a huge undertaking. And I also think we haven't talked about this much on the show, but the methodology for assessing those herbs is a methodology that's super fascinating that there just isn't a lot of training around in our field. So that's called organileptic assessment. Organileptic assessment. So that means that you would use your taste and smell to determine particular aspects of an herb. This organelleptic process, super, super common in beer and wine and coffee. So if you are a trained somalier, part of the work that you are training on is organileptics, the ability to smell something and identify it consistently in a product. So what happens then, in order to do that is you train up on specific smells. And so, like, for example, you'll get a book full of chemical vials that will have a smell compound inside of it, and that smell compound will be given a name. So, like, this compound is wet straw, right? And then you smell it, and you think to yourself, I don't think that smells like wet straw. It doesn't matter. Your opinion about whether that smells like wet straw is not the thing we're assessing. What we're trying to do is train that when you smell that smell, you write on the paper, wet straw. That's what you're doing. And then what happens with organileptics over time is you say, like, okay, not only do I smell, taste wet straw, but it's on a scale of, like, one to nine, right? One being little and nine being a lot. So then you say, like, okay, this is seven wet straw, and it's eight mushroom, and it's three cut grass, and it's four fish, right? And you're like, oh, my God, how could those things be in it? Well, don't get bogged into the details about which smells go together. Just that once a trained panel of people can do an organelleptic assessment, you compare their results. You take an average of the results, and then based on those numbers, you now have a profile for a plant, right? So plant X is now, on average, six wet straw, two fish, three mushroom, five wet grass, or whatever, right? That's now the profile for this herb. So if you, say, had really high quality dangue, and you had people assess that Dongwei, you had some trained organelleptic assessors assess that dangue. They make a profile for, quote, high quality dongwei. So now you can compare that profile to other dongwei to be able to say, like, is this as high quality as the other right. That's one way to do it.
[00:54:40] Speaker B: By Dongwei, you mean Dong kwai.
[00:54:43] Speaker A: Dong kwai. That's right. That's what I meant. Sorry, that's the inside joke, you guys. It's the pet peeve of mine. Dong kwai. It's not people's fault. That's how it's written. I know, but anyway, yeah, good old Dong kwai.
So you would be able to assess good quality dongwei using that. But you'd also then be able to compare that profile to other herbs that are not dongwei, that have a similar flavor profile, similar organic profile. And based upon that similarity, you might be able to guess that this herb might function somewhat like dongwei. Yes. Right. So this would be the way that we would be able to systematically, I think, start to understand western herbs, where we would sit down with western herbs, and we would put them through organileptic testing. We'd come up with a profile of those. We'd compare that profile to chinese herb profiles that we already know a lot about. Right. And we'd find commonalities. And then based on those comparisons, you would then be able to say, like, yeah, okay, this has similar properties to dangwe. Also, it's probably warm, like dongwei is warm. It probably has these other qualities, because if the taste of the nature and the flavor. I mean, I guess in this case, we're really assessing flavor, but if the flavors are roughly in the same ballpark, probably the herb has very similar qualities in terms of nature and flavor. Right. Just because that's how plants work, they have a kind of commonality. So it's absolutely doable. We even here at Rooden branch, we bought some of the testing kits, the ones that you use to train people on. Frankly, we just never had the time to actually train ourselves to do it.
[00:56:23] Speaker B: An extra work week to be able to devote to that.
[00:56:28] Speaker A: I'll tell you what, though, man, it's still a big piece of my mind. I think it would be so cool.
[00:56:32] Speaker B: That'd be great.
[00:56:33] Speaker A: I haven't figured out how to do the training because you also can't just do it by yourself. I mean, you could, but you need a little panel.
[00:56:41] Speaker B: You need calibration, like you train pulse or abdomen or anything like that. You're training a sense.
[00:56:47] Speaker A: Yeah. The standard is three people. Three people panels. But probably it'd be better with five person panels. So that means you need five people who are reasonably trained in this skill, and then they would all do these assessments, and then you would take means, probably maybe medians but means of those results and repeat them. So if anybody out there has already done this work or, you know, of people who are training the work, let us know. Shoot us.
[00:57:12] Speaker B: We would love to connect with some.
[00:57:14] Speaker A: People that, because I think it's the real way to do it. It also helps to solve some of the problems we were talking about, because there are some western herbs that are being produced at enough of a scale that they'd be affordable. Yes. And so if you could figure out a way to substitute out some of the very more expensive herbs, like Bancha is getting super expensive, Sanchi is expensive, Yan Husso is getting expensive. Like figuring out ways to take herbs that we use a fair amount and being able to substitute them with something else using this organileptic method, I mean, that would be massive.
[00:57:51] Speaker B: It'd be great.
[00:57:52] Speaker A: Be a game changer, a really cool skill. Also just a great way to develop your own relationship to the herbs. Yes. Right. Like getting to that macro knowledge that we were talking about earlier, understanding that Shao chai Tong is made of those herbs, for sure, but it's actually made of nature and flavor. Right.
[00:58:10] Speaker B: Flavor, nature. And signature is the third hidden one that's involved, I think.
[00:58:16] Speaker A: Absolutely. And so if you have those three things and you understand those metadata points for that formula, then you can figure out a way to make it work another way. So organileptic training would be another way to really internalize that knowledge. Right.
All that to say, if you're out there thinking about getting into herbs, doing more herbs, what's your approach into that space? Where do I get them from? How do I buy them? The whole reason that we gave this talk today was really to illustrate the fact that there are people, a lot of people, we're some of them, we know a lot of other people who are already doing this. This is what we like to do. We're already thinking about it. We're already figuring out the answers to these big questions.
So in many ways, you don't have to.
[00:59:07] Speaker B: Right.
[00:59:08] Speaker A: That's kind of the thing. Do you like clinical work? Like you want to work with patients and help them feel better?
Great. You don't have to spend all of your extra time trying to figure out what the trajectory is for domestic herbal production. Right. Because there are people who already are doing that. Right. And so all you have to do is connect with those people, make sure that they are aligned with your values significantly enough to work together well, and then basically outsource it. Right. Why don't you outsource it? You don't need to build a pharmacy and stock it with all your own stuff. Right. There are pharmacies all across the country who are doing it, people you can trust who are coming from good suppliers. And so cut yourself some slack. Yeah, focus on the clinical stuff. Also, on the flip side, if you love this, also, there are a lot of people you can talk to about it. There's people already doing the work. There's people who are looking to get into this element and expand it even more. So that's an option.
[01:00:07] Speaker B: Yeah. We're always open for talking about this stuff.
If you're looking to start a pharmacy and you want to talk to somebody about how it could work and what the specifics are, you can always give us a call. We're very open about sharing.
Hopefully some tips so that you don't have to struggle.
[01:00:27] Speaker A: Absolutely.
[01:00:27] Speaker B: The same way that we did when we opened.
[01:00:29] Speaker A: Yeah, I've got template startup docs for folks. Right. Like, if you want to know what we think the starting bundle of herbs you should buy are and what those costs look like and equipment and pricing and other tools like online services, inventory management, we have all that stuff, all that gritty kind of businessy stuff that makes a lot of people's skin crawl, don't worry, we've got it. We're happy to share it with you. And that way you can make an informed decision, right. You can decide, do I want to spend my energy, time, and money building out something like this because it's easier for me, faster for my patients, et cetera? Or do you want to outsource it to somebody who's already doing it? Because I think think that either path is fine. I think it's just a matter about you figuring out what's going to work best for you. And this is the best part about living in the era that we live in, right, is that this stuff is available.
It wasn't that long ago that if you were living in a rural place or not the west coast or not the east coast, you were kind of up the creek. You had to build your own pharmacy. There really just wasn't any other way to do it. But that's not the case now. I mean, there are pharmacies taking email orders. We use our online system, right? And there are companies doing direct drop ship to patients. There's people doing wholesale white labeling. I mean, there's just so many options out there that if you want to get herbs into your practice, it's easier now than it ever has been.
[01:01:56] Speaker B: Right? So just to remind people of what we do. Do you want to go through and.
[01:02:00] Speaker A: Yeah.
Our pharmacy is a web based pharmacy, which means to say that you can build your practitioner profile by going to rootandbranchpharmacy.com. It's all spelled out, rootandbranchpharmacy.com. You build a practitioner profile. Once you have a profile, you log into the system and you can build granule formulas and bulk formulas. Right. We also have a collection of some patents and topicals, and software is a piece of software that's developed actually by a practitioner in Canada. And it's called dispensary tree. And dispensary tree is an evolutionary, it's an evolving product as well. So it's really come a long time since we've been using it, and it's constantly adding new features. But basically you make a formula for your patient, and then the system will let you pay for it. If you want to collect money from your patient yourself, or it'll let you send a text message or an email to the patient, and then the patient will pay for it. Right. Once it's paid for, our pharmacy makes it and then either sets it up for pickup. If it's local in Portland oR. We ship. We ship all over the country into Canada. We ship to all the states. So we do that pretty regularly. And then the other thing that's really cool is that the system will let you add a markup for your own profits, right? So let's say the herb costs, it's like $25 for the formula, and you add a $5 markup so the patient doesn't know that you've added a markup. They just see a $30 fee. They pay the fee. We collect the $5 on your behalf, and then once you've got $50 or more in your account, you can request it back in cash. Once it hits $150, I'm going to cash it out for you just so that it's off my books and I don't have to deal with it. Or you can use it for credit in the store if you want. But it goes both ways. A lot of places are only offering store credit, are offering cash back to you. Right. We'll collect it for you. You can request it. So that way there's a cash incentive as well. And almost all of our practitioners add markups. So $2 here, $3 there, 10%, you can do it any way you want. And so the real gem there is that you can prescribe effortlessly. It's online. You just type it in, submit, done. Right, you don't have to stock anything. You don't have to supply anything. And shipping in the US is pretty can. Most of our shipments are even going from Portland all the way back to DC in three days. And if it's anywhere on the west side of the country, it's a day, or know a tri county area around Portland, it's next.
There's a. There's a lot of options there for what's possible, and we're not the only ones doing it. I'll say we're some of the fastest people. I'm going to plug us a little hard. We're not the only ones, but we are pretty.
[01:04:33] Speaker B: We care a lot about creating a good product and serving people and being fair. And so it's important to us that the job gets done and it gets done well. Also, if you guys are thinking of writing a formula for a patient, maybe you're a little new to the process and you're not sure. You can always give us a call and ask to talk to a Travis and one of us, we might not be around right then, but we will give you a call back and you can talk through the cases. We do that all the time for people.
We're here to support you guys.
[01:05:10] Speaker A: That's ultimately the goal. Guys like Ruden branch says the pharmacy spoke of, our business is fundamentally oriented toward helping practitioners do what they want to do better, right, easier, faster, smoother, all those things. Because we are you. Like, we're in the same boat. We know how much effort it takes to go into work in your business and on your business and try and figure out how to make all those things work. And so one of our major goals from the day we opened, and I think will remain a goal of ours to the end, is that we want to make things easier for people like you, people who are trying to do this work, because people like patients need it, right? The world needs it. Not to get too soapboxy about it, but what we do is important. It matters, and it changes lives. And if it's easier for you to do that, easier for you to deliver high quality medicine and get good results, that's what we want. Because, honestly, that floats all our boats. I mean, it's the classic rising tide model, right? It really does float everyone's boat. So we're here for you guys if you need us.
[01:06:07] Speaker B: Yes. And we have a residency program that's in its second year of iteration, so we're used to talking with people that have a little bit less experience about cases and providing support absolutely.
[01:06:20] Speaker A: Yeah. It's all skill levels, right? If you've got questions, we're happy to talk with you about it and figure out how to get you what you need.
[01:06:29] Speaker B: All right. I think that's pretty good for today. We covered a lot of ground.
[01:06:34] Speaker A: Absolutely. All right, guys, thanks for listening in again. We really appreciate it. You can always find
[email protected]. If you want to give us a call, we're in Portland, 971-288-5939 we are in the shop Monday through Friday, 09:00 a.m. To 04:00 p.m. Pacific time. Give us a call. If you got a question, leave a message. We'll get back with you. And as always, if you guys have any suggestions about topics you want to hear about or things that we haven't covered, shoot us an email at info, that's info at root tanbranchpdx.com and we'll get back with you. Thanks for listening. Thanks for listening. We'll see you next time.
