The Herbal Pharmacy Process: Steps to maximize you and your patients' experience at Root & Branch

Creating new habits and getting comfortable with new systems can sometimes be challenging. At Root & Branch, we want you to feel comfortable with HerbaScript™, our online ordering system so that you can write formulas efficiently and effectively. So I wanted to highlight a few key items to getting started with HerbaScript™

Pharmacy Essentials

1. Root & Branch only prepares herbs that have been paid for
   In order to keep costs as low as possible and to minimize waste, our pharmacy only prepares herbs for which payment has been received. Fortunately HerbaScript™ will send a payment link via text and/or email to your patient so that they can pay for those herbs. As soon as payment is received, we will get working on the formula. If you would like your patient’s herbs to be made as soon as the order has been placed, you can always use the Vouch System in your practitioner settings to make that happen. More on vouching in future posts.

2. Preparation times may vary
   Depending on how many formulas the pharmacy is processing at any one moment, the time it takes for your patient’s herbs to be prepared can vary. This variation is especially true for decoction, grinding, and encapsulation services. If you or your patient would like the most accurate estimate of preparation time, it is always best to call us directly (971) 288-5939

3. We Will Make It EXACTLY As You Submit It

   We prepare a lot of our herbs ahead of time to maximize their use like crushing zhi zi or splitting xing ren but other herbs can be prepared in a variety of ways depending on what you want to achieve with your formula. So you need to tell us about any special instructions you want for any particular ingredient. Use the “Special Instructions” at the end of the formula build screen to tell us.

   A lot of the folks that work in our pharmacy are Chinese Medicine practitioners themselves, but not everyone is. So we train our staff to make your formula exactly as you send it. Want your Gui Zhi short-boiled? Then make sure to choose “add at the end” at the end of the line where you added that herb into your formula. Want the Fu Zi preboiled? Make that selection. Want us to crush the rou gui into powder? Type that into the special instructions section.

4. More information is better
   In all cases, communicating more and detailed information to the pharmacy is best. Use the special instructions section at the end of the formula builder to tell us what you need or want, and if in doubt, give us a call (971) 288-5939. If we don’t have essential information about your formula like dosage (number of bags or jars per day for example), then it means we can’t dispense your formula until we talk to you, which can take time and slow down your patients getting the medicine they need.

Our Herbal Catalog and Organization

Regardless of what type of herb administration you choose, some factors will be important for all types of formulas:

1. Patient Name
   Make sure to put your patient’s name on every formula. This creates continuity from prescription to prescription and prevents errors and confusions as to which formula belongs to which patient

2. Formula Name
   The system will not let you advance without writing a formula name. Most people name the formula with whatever classic formula their custom creation is based on (i.e. Xiao Yao San, Ding Zhi Wan, etc.) but it can also be helpful to name the formula something that reflects what you are using it for (Insomnia Formula, Stress Relief Formula, etc.) or even a name that has some sort of numerical progression that might correspond to your chart notes so that you can preserve your thinking for each change you might make to a formula (Formulation 1 become Formulation 2 when you add Ban Xia, for example)

3. Dosage and Dosing Information
   Depending on the type of formula you are writing, what you choose for dosing will be different, but make sure that you are telling the pharmacy and your patients how you expect this herb to be dosed (1 bag for 2 days for raw, 3g BID dissolved in hot water before meals for granules, etc..) Making sure that your dosing information is clear is essential to making sure that your patients understand how you want them to take the herbs and how the medicinary should package those herbs for them.

4. Setting refills
   Making sure that you include number of refills and the number of days between those refills is essential to keep your patients happy. They will invariably call looking for a refill of their formula and if you haven’t included that information when you wrote the formula, a long and arduous came of phone tag will ensure while we try to track you down and get that information, creating frustrations for your patients while they wait.

When you are writing a formula, you’ll need to decide if you are going to use a bulk (raw), granule, or patent administration.

If you choose the Bulk (raw) form, you’ll want to pay attention to a few specific items:

1. Work section by section
   Each section on the formula ordering screen contains important information that you should consider with every formula you write for your patients. Please look at each section and the information for that section on the right side of the screen to make sure that you are including all the necessary information for your patients and the pharmacy

2. The price of raw herbs changes by quantity ordered
   As you add herbs and grams into the formula builder, the price per gram and for the total quantity will be displayed. This price is higher for smaller quantities of herbs and lower for greater quantities. As with most things, buying more of a product can bring the price down. We have placed those tiers of prices at levels that reflect the price of each individual herb, its frequency of use, and the common dosages for those herbs such that dosing in the upper range of the standard dose will yield the best price for that herb.

3. Add specific instructions at the end in the “Special Instructions” section
   If you want the medicinary to do something special with your formula, beyond the inputs you entered in other sections like short-boil (i.e. package it all in one bag, grind half of it into a powder and leave the other half whole, tell the patient something specific when they pick up their herbs), this section is place for that information. If you feel like your instructions are confusing or aren’t getting your message across, give us a call and talk to a pharmacy person directly (971) 288-5939

If you choose the granule form. there are some different items to consider:

1. Root & Branch stocks a large collection of pre-blended formulas
   (You can take a look at the list here) These formulas have been cooked together and then made into granules, preserving the original synergy of the formula. You can use a whole formula granule by typing its name in the herb builder like you would with a single herb. You can even mix whole formulas to blend their various properties into an elegant combination that can get at multiple presentations at once.

2. Use relative ratios to build your formula and let HerbaScript do the math

   When building a formula in granules, you have to tell the system your dosage (6g BID for 7 days for example) before you input your ingredients. The software knows how much total herb you will need based on your dosage parameters (84g total for the above example) so all you need to do is put in the formula ingredients relative to each other and not in true numbers. For example, you could build a Gui Zhi Tang with Gui Zhi 12g, Bai Shao 12g, Zhi Gan Cao 9g, Da Zao 6g, and Sheng Jiang 6g, and the software will take those numbers, interpret them as ratios, and spit out the actual weight of each ingredient to get you to your requested total of 84g. It’s super convenient!

3. Dosage is key

   Choosing the right dosage for your patient, their condition, and their level of tolerance is as important for granules as it is for bulk herbs. Read more about granule dosing specifics here.

Remember, we want to help you do what you do best.

Have an unconventional item you want to try and make? Looking for Sans, Wans, or Gaos?
We can help make that a reality for you.

Give us a call (971) 288-5939 or send us an email info@rootandbranchpdx.com so we can talk about how we can help