If herbal medicine can be practised safely alongside conventional healthcare, why don't more herbalists work within mainstream healthcare?

This is something herbalists think about a lot, it is all healthcare after all. A herbalist sitting within a mainstream healthcare setting feels unusual, because right now, it is.

It does happen. The herbalist Alex Laird runs the herbal medicine clinic at Whipps Cross University Hospital's Dermatology department (I had the opportunity to do clinical hours with the clinic myself during my training). So, the model works. It's just rare.

I think one of the biggest barriers to herbalists integrating into mainstream healthcare is that we don't have statutory regulation. The government decided against it back in 2015, following recommendations in the Walker report. Many herbalists are still hopeful this comes back into discussion as it's seen as an ideal route toward proper integration, but it's not back on the table again yet.

What that absence means in practice is that the title "herbalist" isn't protected. Anyone can use it, regardless of their training or competence. Someone could have little to no training, no accountability to any professional standards, and still call themselves a herbalist and in the worst cases, claim to treat serious diseases, including cancer, without any real consideration of what that implies.

That's where professional associations come in. I trained to a level and with a school that lets me join both the National Institute of Medical Herbalists (NIMH) and the College of Practitioners of Phytotherapy (CPP), and both have standards of practice members are expected to maintain. In real terms, that means knowing when herbal medicine is appropriate and when to refer someone on to their GP or another practitioner. It means knowing the red flags to look out for, and knowing how to check for interactions between herbs and conventional medication. It means understanding privacy, confidentiality and safeguarding. And it also means working within the legislation that governs how healthcare can be advertised and provided (including consumer protection law around misleading claims, and the Cancer Act 1939, which specifically prohibits advertising that offers to treat cancer or advise on its treatment).

I'm not saying I'm for statutory regulation, it has its downsides too. What I'm really pondering here is how herbal medicine can work more alongside "mainstream" healthcare, and what the barriers are to people actually accessing it in the first place.

Because regulation aside, I think a lot of people still don't understand the complexity of herbal medicine. It's easy to be seduced by quick fixes and one-size-fits-all protocols, I’m susceptible to this too! They're simple, they're everywhere, and they promise fast answers. When that's the expectation people bring, there's less pressure to make space for something like herbal medicine, which works differently. Herbal medicine and my approach puts you at the centre of it. Your care, your health, your privacy are all my priorities an the time we spend in consultations is a commitment on both sides. That’s a much harder thing to explain than a quick fix. So, I find myself wondering how else we spread the word about what herbal medicine can actually do, in a way that builds the kind of public understanding that could eventually support better integration.

There's also the research side of things. Herbal medicine tends to be individualised, as the treatment is tailored to the person, not just the diagnosis. That makes it harder to fit into a conventional trial design which is built around testing one intervention against one outcome. So, the evidence base looks less than it does for a lot of established healthcare professions. That's not the whole story though; pragmatic and whole-systems research methods exist and are increasingly being used to study complex, individualised interventions in ways that actually reflect how they're used in real clinical practice.

Statutory regulation wouldn't fix everything, maybe it would close a lot of the gap. Until it happens, it's really down to individual herbalists like me to demonstrate competency and safety in person - one relationship at a time, with the mainstream practitioners we hope to work alongside.

And honestly, that's often where the real barrier is. It's not usually scepticism. It's time. Busy medical professionals don't often have the space to look properly into a field like herbal medicine when it sits outside their usual referral pathways. So, integration happens slowly, where it happens at all — through people getting to know and trust each other, rather than through any big systemic shift.

Any questions or thoughts? Let me know?