There is a persistent assumption that because a substance is natural it is therefore inert. This is false, and it is the source of most serious problems in herbal practice. Herbs contain active compounds; that is why they do anything at all.
The practical consequence is that a herbal prescription needs to be considered alongside whatever else a person is taking. Some herbs affect how quickly the liver clears other drugs. Some accentuate or oppose the action of a conventional medicine. Some are simply not appropriate alongside particular treatments.
Good practice means asking, recording and reviewing. Any herbal practitioner should ask for a full medication list, including over-the-counter products and supplements, and should be able to explain what they checked and why. This is exactly the standard we teach, and it is assessed before a student reaches the clinic.
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What this means in practice
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