For practitioners of Chinese herbal medicine in North America, one of the most significant obstacles has been patient compliance. While it is possible to initially convince patients to take water-extracted decoctions, enthusiasm wanes dramatically after three weeks. There are three main reasons for this: 1) The taste is not agreeable. 2) The patient does not like the effort and time that it takes to boil down herbs on a daily basis; also, the smell in the house is often objectionable. 3) The price is excessive, often costing the patient $3 – 7 per bag per day, or $60 to $140 per month. In America, we often use 100 grams of herb per bag, and try to get three doses out of it, lasting one and a half days. In China, one bag might be two to three times the dosage, and meant to last one day. Which is to say that this approach, when practiced in North America, is often less strong (and effective) as is practiced in China.
So, compliance is affected by hassle and cost. Practitioners, many of whom recognize this problem, have tried to circumvent it by using ready made Chinese herbal products. This, of course, inhibits the herbalist’s effectiveness in customizing an individual formula. For those herbalists wishing to individualize patient’s prescriptions, there are three methods for reducing the cost and increasing compliance on the part of the patient.
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