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  • Writer's pictureAmy

What you don't see: the cost of holistic care.


Shelf of herb books

I can’t afford me.


It’s true. As I’ve been spending the last 3-4 years building a couple of businesses from scratch it has been a newish accomplishment to financially break even, but I could not afford to work with me. I still can’t. 


When I break down the amount of hours spent working on a client and their case, most of the time I end up making a little more than what my son makes working in a warehouse. Sometimes, it ends up being minimum wage. It depends on how complicated the case is. 


I am not alone in feeling the need to justify my prices to the general public. I know a lot of other holistic practitioners who also feel frustrated at the money part of the practice, which can be a major factor when clients are deciding to book a session. I hate talking about money. I hate dealing with money. I hate the whole money part. It’s icky. We didn’t get into this to make money- we’re healers. We want to help people. But I also recognize the need for money. I am a horrible businesswoman because I am not out to make a buck. I am out to help others and unfortunately I cannot continue to do that without money. However, I suck at making money. 


Those of us that can’t offer insurance (like herbalists) have no option but to put out there a price that works for us. It’s tricky to figure out what to charge. What my family needs to survive is not always what people are willing to pay, especially when you live in an area which is less affluent than others. And having to consider the month-to-month fluctuations in clients makes it even more complicated. 


I can’t speak for all holistic or integrative practitioners out there, but I know a lot of us are putting way more energy and time into your case than you realize. 


Today I want to talk a little bit about what you don’t see. 


As a clinical herbalist who also formulates for clients, most of what happens you will not see. 


Before I meet with you for your intake, I look over your health history and intake form. If you haven’t seen it before, it’s pretty thorough. I take notes on what you have provided. I color code my notes based on what you provided, what I’m thinking about, and what questions I plan on asking when we meet. I’m looking for patterns- areas where your symptoms or issues overlap as I try to piece this puzzle together. 


I also begin the research process, which is usually necessary. What am I researching? Mostly medications and supplements as I look for contraindications, herb/drug interactions, and side effects which may be contributing to the issues. But if you have a diagnosis I haven’t worked with before I’m probably spending a few hours learning the ins and outs of what I need to know to ask the right questions. My ‘pre meet with you’ planning takes about 1-3 hours depending on complexity. 


Then we meet for an hour. I take notes as we chat.  


After that I spend time organizing my handwritten notes (all color coded 🙂) and type them up into my Practice Better software. I look over your case. Most likely I will end up doing a whole bunch more research as I piece things together. I start more color coding with Phase 1 and Phase 2: what we are going to tackle first and what will come later so that I don’t overwhelm you with all the things you could do. This takes about 2 hours.


Then, the fun part (for me)- herbs.


I make categories of areas we need to focus on, whether that’s anxiolytics, tissue repair, inflammation, etc. In each of these categories I write down herbs that work in those categories, hopefully finding ones that overlap- EX: Chamomile is relaxing but also great for digestion. I consider if we should be using a tincture, or a tea, or a powder. I start to decide which herbs match your constitution, such as whether you run hot, cold, dry, or damp. In my practice I try to create balanced formulas for both you AND the energetics of the issue you’re having. Once I have an idea of the herbs I want to use I have to make sure: I’m not mixing too many things together; it isn’t going to taste horrible; I’ve looked up the therapeutic dosage for each herb; it is a balanced formula; there aren’t any issues with the herbs I’ve chosen and your medication/ supplements.


But wait- there’s more!


Usually I have folks take their herbs for 3 weeks before we meet again. Next I have to decide how much of each herb to use and measure out how much of each herb for 3 weeks. But you’re usually taking it more than once a day, so then I have to factor in how many tablespoons a day 3 times a day for 3 weeks….and grams to tablespoons and...math. This formula will end up being sent to a dispensary (more time spent) or I can blend it myself from my apothecary (even more time spent). And THAT’S just for one herbal formula!


I also need to put together a protocol for you which also includes lifestyle recommendations (and how to do/ acquire the recommendation), dietary recommendations, and supplements if we’re incorporating those. And- yep- adding in how to get those, too. 


Then I put it all together into the protocol that I send you. All in all, this post-meeting part typically takes me about 3-4 hours, depending on the case. The initial intake is always the most intense. Follow Ups require less work. 


Sometimes, I like to get some feedback and bring your case to my Monday Mentoring meeting, which is where I anonymously share (with your permission) some info from your case to get suggestions from 10-20 other clinical herbalists. Other times I might need to touch base with another of your practitioners to make sure we’re on the same page. More time spent. 


And because I encourage clients to use the chat feature in Practice Better if they have questions or concerns, I am usually spending time outside of the times we meet still working on your case. 


In our first month of working together, you are on my mind at a minimum of 8 hours. Because clients only ‘see’ me for an hour or 45 minutes they think that is what they are paying for. In real life that is the least amount of time I spend thinking of you. 


Life would be much different if I worked from the allopathic model. I could do a ‘give this for that’ approach with herbs. It would be easier for me, but the results for you would be much different. And, that’s not how this was meant to be. 


I doubt you find this much care and attention from today's medical professionals. I know I don’t. My dentist doesn’t know anything about me. My PCP barely knows my name. But I get it- they have many more people to see and there usually isn’t time to get to know the person. 


Just so you know- holistic practitioners care- a lot- about you. We think and worry over your case and what you’re going through. At least, I do. Sometimes it keeps me up at night, which is ironic when I specialize in sleep disturbances. 


I didn't even scratch the surface of the financial costs of websites, insurance, software, continuing ed, paying off school loans, etc. 


Again, I can’t afford me right now. Hopefully one day that will change. My long term goal is to be able to be in a place where I see enough clients to be able to offer a sliding scale, or to offer free consultations to those who can’t afford it. But right now, that’s me. 


Sometimes the herbs are what are most needed, and sometimes it’s just holding space for the person who feels alone or unheard. So just know that when you’re working with a holistic practitioner, or, at least, me, you’re paying for more than your Zoom call. 


I hope this helps. 💕


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