Sitting in a tiny taupe office with a big red bookcase in south Lexington, herbalist Andrew Bentley gives people plant-based concoctions. He also gives them that rarest of commodities in the medical world: time.
Lots of it.
From the first visit, Bentley — who is from Lee County but whose family traces its roots to Ireland, where they worked in herbal healing — spends time talking with patients about what's bothering them now and what their health history has been.
Bentley will ask his clients about diet, lifestyle, exercise, medical history.
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"I'm trying to get a sense of which structures of the body are working the way they need to be and what are not," he said.
At the end of the appointment he will dispense an herbal remedy, although it might not be the same for two individuals with the same complaint. People are different, Bentley said, from weight to health habits to severity of symptoms.
In addition, Bentley might use other alternative therapies. Those include cupping, which involves warming a glass container and holding it to the skin to stimulate circulation; moxibustion, the burning of an herb for therapeutic purposes; and Gua Sha, also known as strigilation or scraping, which involves rubbing a thin object across the skin to produce friction and warm the tissue.
Bentley studied anthropology and linguistics at the University of Kentucky and remembers when herbalism "was looked at as a fringe thing or maybe a fad."
But knowledge of herbs that have been used for hundreds or even thousands of years is passed between generations, Bentley said, including generations of his own family, which led him to herbalism.
"We know a lot about them compared to say, what we know about a new drug," he said.
"There are herbs for all kinds of things, and some herbs that are more popular than others," Bentley said.
Most Kentuckians are familiar with ginseng, with benefits said to include improvement of immune and nervous systems; garlic, which some think can control cholesterol levels; and turmeric, which can be used as an astringent and has anti-inflammatory properties.
Bentley, who has been treating people since 1992 and has had an office since 2000, considers himself an apothecary rather than a compounding pharmacist who works with conventional drugs, but he said the most important part of his job doesn't involve a mortar and pestle.
"The feeling that you're being listened to, it's a quality-of-care issue," he said. "It is individualized. It's not just a rote condition where if you have condition X you have drug Y."
Herbals have a place in patient treatment, but patients have to be careful to educate themselves about all substances, both herbal and pharmaceutical, said Peggy Piascik, associate professor in the Department of Pharmacy Practice and Science at the UK College of Pharmacy.
Piascik suggests people not pick up a bottle off a pharmacy shelf that is touted as "support" for some medical condition.
"If you're a forward-thinking health professional in the United States, (you know) there is usefulness in these products (and) that they can be used within the health care system," she said. "What we're concerned about in pharmacy is the evidence-based research for these products. ... An informed consumer is very, very important."
And, she adds, "I'm more confident with an herbalist than with a lot of products that are sold in pharmacies."
While consumers might think that medical products sold in drugstores are regulated, dietary supplements are more loosely controlled than pharmaceuticals. In some cases, she said, the most popular dietary supplements — such as those for weight loss, male enhancement and body building — might be spiked with prescription drugs that the consumer doesn't know about.
When in doubt, Piascik said, ask your pharmacist. The problem, she said, is "you don't necessarily know that question you should ask."
Visiting an herbalist is an experience far different than that of visiting a pharmacy, with its chutes and shiny caplets and neatly clustered foil packets.
There aren't many instances when Bentley can't help improve a patient's condition with herbs, from pain to depression to sleeplessness, he said. Part of the appeal is the longevity of the knowledge of herbal cures.
"We know a lot about them compared to say, what we know about a new drug," Bentley said.