What I’ve learned from thirty years in practice
Hi I’m Gill, a naturopath and herbalist who loves mentoring health practitioners. This article is written to share my backstory and some observations with colleagues about how our industry has changed in the past thirty years. If you’re only got time for a few takeaways – they’re in the box below. But if you want the deep dive…keep on reading!
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This week I turn thirty! Years in practice that is. I first hung my shiny plaque on the clinic door in late February 1992. Three decades on a lot has changed, yet some things have stayed the same.
Biggest changes in 30 years
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Where it all began
Before starting my Diploma of Applied Science (Naturopathy) at the Southern School of Natural Therapies, I’d completed a BA in political science, worked in the not-for-profit sector and government departments and backpacked around Europe. But those four years of full-time study combined with part-time work, were more challenging than anything that I’d done before.
The harder it was (two years of monthly chemistry exams culled many aspiring naturopaths), the more convinced I felt about pursuing this career. But if all the science subjects had stretched me, it was nothing compared to the first year in practice.
Setting up a business with little or no money after four years of upfront fees and no Austudy called for ingenuity. Our previous life and work experiences are resources to mine in business and serendipitously I had the opportunity to leverage my student radio experience with a gig on 3RRRFM that lasted for 20 years!d
While establishing my practice, I undertook other free or nominally paid gigs that helped grow my reputation and attract new clients. Other than the talkback program, I wrote articles for a variety of media and presented community classes on natural health. Each experience encouraged me to upskill and grow my knowledge.
Early influences
I don’t know if I’d have made it this long if my SSNT lecturers Sue Evans and Assunta Hunter hadn’t started VicHerbalists a couple of years before I graduated. The meetings and friendships provided informal mentoring that helped me grow as a practitioner and remain connected to the plants.
As an early adopter of the internet, in 1994 I managed to fall down the right alpha-numeric rabbit hole to connect with Jonathan Treasure, a UK trained herbalist living in Oregon. That grew into a friendship and an introduction to a herbal mailing list with US legends such as David Hoffman and Michael Tierra. Herbal Hall continues to this day.
Feeling part of not just a local herbal community but an international one peppered with herbal icons, had a profound influence. We now know that isolation is one the biggest challenges facing emerging practitioners. Finding a tribe of like-minded peers and elders kept me inspired and supported, while I found my feet in the profession.
With Sue Evans at the first NHAA International Conference 1992
Mentoring
When a mentor encourages you to level up, it’s hard to say no. I didn’t feel ready to teach fourth year herbal medicine students a few years after graduating. But I accepted Sue Evans challenge to take over her SSNT class and develop a herbal curriculum for the proposed bachelor degree. This was a massive learning curve but provided an incredible opportunity to take my understanding of herbs to another level.
After a few years, I needed to decide which way to go. Continue lecturing and undertake post-graduate study, or care for 40 plus patients a week in my thriving multidisciplinary practice? There just wasn’t enough time for both. I’ve always been passionate about being a clinician and running a business (and realistically, that was a lot more lucrative than teaching). I stepped down from lecturing but it inadvertently opened a new chapter in my career.
Working with final year students highlighted how unsupported many graduates feel when going into practice. In 1998 I set up my first mentoring group to help bridge that gap, offering both professional supervision of cases and patient management, along with business support.
Running the inaugural group spawned a new passion for mentoring practitioners in all stages of their careers, to help be more effective clinicians and business owners. I took this up a notch after taking my practice fully online in 2014, with virtual groups and webinars, as well as individual sessions. Offline, Charmaine Dennis and I created a beautiful collaboration, running three amazing practitioner retreats in Bali and a number of local workshops.
Creating a virtual practice
Owning a business means you’re perpetually refining and growing. In 2013, as far as I could find, there were no other practitioners who’d closed their clinics to go entirely virtual. I spent the year researching the ethics, legalities and practicalities involved and sought the support of a gifted coach to guide me through the transition. There were also logistics to work through including securing a reliable internet connection, online meeting platform and insurance. Only one association was open to online consultations at the time (though during those first few years they changed the rules a number of times, which was a bit nerve wracking).
While mentoring slipped perfectly into my new virtual practice and took off, in 2014 some naturopathic clients were initially hesitated to adopt this new way of consulting (long before anyone had heard of Telehealth or Zoom). The situation wasn’t helped by private health insurers only rebating in-person consultations. But as rebates for naturopathy and herbal medicine were dropped a couple of years later, this didn’t remain a barrier for long.
By the time our world got turned upside down by the pandemic in early 2020, my clients were already onboard with online consults so there were no disruptions to practice. Since moving online, all bookings are made and paid for online beforehand, Zoom links are embedded and external dispensaries provide herbal and supplement prescriptions for clients.
What’s changed in thirty years?
Ten years ago I documented some of the major shifts I’d observed in our clients and the naturopathic landscape during my first two decades of practice. But what about the business of being a naturopath, herbalist or nutritionist and our professional standing?
There are more practitioners but the demographics remain unchanged
There’s exponentially more naturopaths and herbalists in practice than thirty years ago. According to the Bureau of Statistics, in 1996 there were 1900 of us (unfortunately the data for 1992 isn’t available but there were definitely fewer at that time). By 2006 there were almost 3,000. It’s estimated by the end of this year there will be 4,600 naturopaths in Australia.
What hasn’t changed is that we are a female-dominated profession with most practitioners working in private practice. Less than a third work fulltime, with part-time or underemployment in private practice being the norm. Under-employment is still common, with a notable disparity in income between the minority who thrive and the majority of naturopaths.
Education and recognition
A Bachelor of Applied Science is now the accepted entry level to the profession, and these courses are no longer delivered by institutions owned and run by the profession itself. ‘Big Education’ now provides all the recognised courses. It leaves me wondering what will happen to naturopathic and herbal education if enrolments dip, as the KPIs for delivering health science education are little different for their catering or beauty students.
My four-year course averaged 20 – 22 hours a week of classroom hours over a school (vs university) year, giving us an extra 10 weeks of curriculum annually. Fees were upfront and cost (in today’s buying equivalence) a little more than half as much as the current degree courses.
On graduating more than half of private insurers offered rebates on naturopathy. Over the next few years all remaining companies got onboard, until the government review canned rebates in 2019. A new review into the rebate status of naturopathy was meant to be handed down in 2020 but has been significantly delayed. It doesn’t feel like we’re any closer to seeing the ruling overturned.
The business of being a health practitioner
Marketing has changed beyond recognition over the past 30 years. Gone are the days we relied solely on word of mouth and a Yellow Pages listing. Now emerging practitioners (understandably) grumble about the time they spend on promoting their business online rather than concentrating on the work of healing.
Keeping up with multiple social media accounts, email marketing, hosting Facebook groups and running challenges and other promotions are 21st century phenomena.
Despite having an established business and strong boundaries around time spent on social media, it still takes a big chunk of non-client/unpaid work hours.
Freedom and an international practice
While the internet can be a time suck, it’s revolutionised my life and how I work. It’s the only way I could become location independent and move to Sydney without having to start a new clinic from scratch. Other than relocating interstate, I’ve had stints of working from my childhood home in New Zealand when needed.
Though I consult with clients around the world, they’re mostly existing clients who have moved overseas or direct referrals. The dream to have a fully global practice hasn’t been fully realised due to a few limitations, including affordable PLI insurance not covering working therapeutically (one-to-one or in group programs) with those living in Canada and the USA. International time zones with more than a three-hour difference can also be challenging for real-time consultations if you want a healthy work/life balance. A fast and reliable internet connection and power supply, continue to be an issue at times within Australia let alone when working from an overseas tropical paradise.
Road testing working from Paradise, Bali 2019
Has working with clients changed?
While the digitalisation of almost everything related to my business and clinical work is revolutionary, has the way I diagnose, heal and manage my patients changed over 30 years?
Evolving research has brought changes in the understanding of our remedies and the treatment of different conditions. The herbal and the nutraceutical industries continue to expand. But so many of our basic tenets remain the same: treat the person not the disease, look for patterns and connections between disparate symptoms, layer treatment so we don’t overwhelm the patient.
For a few years in clinical practice I occasionally flirted with food allergy and other tests but can’t think of a single client I’ve referred in the past seven years. The testing landscape has also grown drastically, along with diagnostic trends like MTHFR, pyrroles, etc.
I’ve found nothing that can replace building trust to get to know a client and skillful interviewing.
Cat tax! Work from home perk.
It’s exciting to be part of an evolving profession and use my skills beyond the confines of clinic. I love working directly with patients and mentoring colleagues but being a naturopath has also offered opportunities to learn how to be an effective lecturer, speak at local and international peer conferences, write expert content for public and peer audiences and appear on a variety of media from radio to television and film. I have guest lectured at Southern Cross and Melbourne Universities, spoken at three large public hospitals and helped industry to develop herbal formulas.
I’m proud to be part of a diverse profession and excited about what the next decade will bring.
What will it look like in 30 years – that’s up to you!
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