What is "Functional Medicine"? - and how has conventional medicine gotten it so wrong

Functional medicine uses a holistic and multifaceted approach to healthcare. It takes into account many aspects of a patient's well being - nutritional habits, exercise, genetics, metabolic health, GI & microbiome function, mitochondrial function, immune health & inflammation, oxidative stress, neuroendocrine function, circulatory health, toxic burden, structural integrity, mental health, and emotional health - to name a few.(1) It looks at disease as a manifestation of imbalance in one or many of these areas. It aims to treat and address these root causes, rather than simply medicate and mask symptoms like conventional medicine typically does.

Functional medicine works to prevent conditions from occurring in the first place by supporting all facets of fundamental health. When conditions do arise, a functional approach considers non-invasive treatments first such as nutritional and botanical medicine, and “alternative” therapies. Unfortunately, the broken system that is conventional medicine compartmentalizes symptoms and conditions, and instead of addressing what caused these symptoms to begin with, it does everything in its power to halt symptoms with medications - which ultimately have their side effects and negative implications down the road. Functional medicine tells us that these symptoms are actually information - our body’s way of telling us something is wrong. By masking and suppressing them, we are doing a disservice to our body’s innate and intelligent systems that it has in place to compensate for imbalance, and alert us when there is a problem.

There are so many problems and challenges when we look at the conventional healthcare system as a whole. Government entities, pharmaceutical companies, academia, and the food industry all play a role in these issues. Here are 5 MAJOR problems that I see:

1. Conventionally trained medical doctors are seen as the standard and first stop for all health related needs and problems

2. Conventionally trained doctors receive on average less than 20 hours of nutritional education - yet how we feed our bodies is the backbone of our health

3. The same people who profit off of society’s illness are the ones creating the protocols and medical systems - which are failing people, by the way

4. Research and data isn’t reliable for individual care, and has been found to be false, biased, and skewed in far too many cases - but it is used as the standard

5. Functional medicine is seen as alternative, secondary, or even excluded altogether

Whenever someone is struggling with a health concern, they typically go right to their “primary care provider” who is typically a conventionally trained MD. When someone is in need of a “doctor's note”, it is required that it is signed by an MD, NP, or PA - all of which are conventionally trained. The problem is, so many symptoms and conditions are a result of poor nutritional and lifestyle habits - an area of health that conventional medicine training overlooks. It surely is problematic that doctors don't receive nearly enough training in nutrition and lifestyle therapies; but I also believe that we shouldn't be solely seeking out conventional practitioners for lifestyle related concerns in the first place - it's just not what they are trained to do. It's like going to home depot for your grocery shopping. They might have a few snacks in the check out line, but you are ultimately in the wrong place for your needs. It's up to us, it's up to YOU to make a change in how healthcare is provided! Conventional medicine practitioners and treatments should be used for what they are good at - emergency and acute care. When dealing with lifestyle related symptoms and conditions, however, you should seek out practitioners who are educated and experienced in lifestyle related issues and treatments - like functional and integrative practitioners.

Even conventional medical schools like Stanford are beginning to acknowledge the lack of nutrition education for medical professionals, and how it is a disservice to both practitioners and patients.(2) There is so much value in addressing the root cause of peoples ailments, and as time goes on, it seems like there is less and less stigma around holistic, functional, and nutritional medicine. People are waking up and realizing that our current system just isn't working.

There is a great amount of conflict of interest behind the world of research, with reportedly half of research being inaccurate.(1) This is incredibly concerning, when we are constantly being told to “trust the experts” and blindly follow recommendations. There continues to be a push towards distancing patients from their healthcare and protocol development(1), with patients being shut down when they bring differing questions or opinions to their providers. I have heard countless stories of doctors warning people against researching their own symptoms or conditions, and questioning their opinions. Patients are treated like they are just too dumb to even understand; just be quiet and follow the doctor's orders. I see healthcare from a DRASTICALLY different perspective. I believe that we should be equipping people with the tools and knowledge to advocate for their own health. We should all be learning to become independent, self sufficient, and healthy - rather than dependent on the medical system, and still sick.

Problems arise when doctors receive kickbacks from pharmaceutical companies - and evidence shows that rates of prescription and doses increase when a physician is associated with a particular drug company.(3) Healthcare has become more about profits that it has about health. Of course, doctors should receive compensation for the work that they are doing. However, as consumers or fellow practitioners that value integrity, it is our right to look into questionable deals and partnerships that go on behind the scenes - and it is the medical systems duty to provide transparency. Patients should be presented with options, and not limited to only the option that their practitioner coincidentally receives kickbacks for; Patients should have the freedom and autonomy to choose their practitioner; and patients should be included in the decision making about their protocol - not made to feel like they have to blindly follow whatever 1 doctor says.

Functional medicine practices around the world show simple yet groundbreaking results. For example, mineral deficiencies are common in our modern world as food and soil has become depleted of nutrients. Some people struggle with symptoms like headaches or insomnia for YEARS, and many times, it can be as simple as something like a magnesium deficiency.(4) If these patients had gone the conventional route, they might have been put on medication that would hopefully mask their symptoms, likely cause side effects, and meanwhile overlook a mineral deficiency - leaving it unaddressed. This would be a somewhat minor case when it is only a mineral deficiency being overlooked… but what if medication is being used to mask symptoms that are warning signs for cancer? Stroke? Cognitive decline? We should be using symptoms as clues to uncover the deeper underlying issue(s).

Conventional medicine looks at an issue and asks “what medication can we use to provide some immediate relief?”;

FUNCTIONAL medicine looks at an issue and asks “IS immediate relief necessary, and if so, what is the least invasive route to provide immediate relief while we dig deeper to find and address the root cause(s)?”.

Functional medicine looks to make fundamental changes, while conventional medicine places “band-aids on bullet holes” - so to speak.

Of course, it is important to note that MOST conventionally trained practitioners are NOT at fault here. They too are victims of a broken and failing system. They are being stuffed full of information, taught to not question things, and are incredibly overworked - leaving them with no chance at providing the quality patient care that they want to give. It is also important to note that there IS a time and place for conventional medicine. The technology and innovation made in the medical field is incredible at saving lives. If I have been having frequent stomach aches, or headaches, or chronic back pain - I would like to see a functional specialist to help address the root cause of my issues and make lasting changes. If I get into a car accident, break my arm, and sever an artery - I would like to see a conventionally trained surgeon. No amount of herbs or bone broth will save me from bleeding out of an artery. And neither herbs nor bone broth are intended to do that! This is where pharmaceuticals like anesthesia, and pain killers, and invasive treatments like surgery might be worth their risks - because the alternative is much worse (death…). However, I would like to mention, I believe it is vital to include functional medicine in the recovery process of a traumatic event like the one I described. Nourishing the body after it has been under a lot of stress and trauma is incredibly important for recovery, and patients aren't often given the time, care, and support that they need in that time - cue the herbs and bone broth. This is a great area of opportunity for conventional emergency medicine and functional medicine to collaborate.

The new systems of care discussed in Integrative and Functional Medical Nutrition Therapy involve getting clients/patients more involved in their healthcare. It seems like many people have given over their lives to the medical system, and are used to being told to take what pill at what time, with their insurance covering costs. This has created an illusive environment where practitioners, the medical system, the insurance companies, and Big Pharma are able to take advantage of clients/patients because they are so far removed from the process. Getting the people involved in their own healthcare plans will not only maintain the integrity of practitioners, but also improve patient adherence and outcomes because they are more invested in their health!

HealthCARE should be a space where clients and patients truly feel CARED for. Being involved in the process, educated and informed about their health, worked with for longer than 12 minutes (the average time spent between a patient and their doctor), and supported in multiple areas of their life would lead to much better outcomes than what we are currently seeing under the conventional medicine model.

While I see so much potential in a more functional model of healthcare, the biggest barrier is going to be working against the giant institutions and processes that we already have in place. This is where I believe that the individual has so much power. Clients and patients should demand the care that they deserve, and seek out practitioners who will offer it to them - and they should vote with their dollar! As for functional practitioners, we need to be creative as to how we provide this care to people. We may not “change” the system that is in place overnight (although that would be great), but we can pave the way by practicing functional medicine with integrity, care, and standing firm in our standards for how we treat our patients.

References

1. Noland, D., Drisko, J. A., & Wagner, L. (2020). 1. In Integrative and Functional Medical Nutrition therapy: Principles and practices. essay, Humana Press.

2. Stanford School of Medicine. Why medical schools need to focus more on nutrition. Stanford School of Medicine. https://med.stanford.edu/school/leadership/dean/precision-health-in-the-news/why-medica-schools-need-focus-nutrition.html#:~:text=Doctors%20have%20historically%20received%20almost,its%20health%20benefits%20for%20patientsLinks to an external site..

3. Mitchell AP, Trivedi NU, Gennarelli RL, et al. Are financial payments from the pharmaceutical industry associated with physician prescribing? : A systematic review. Annals of internal medicine. March 2021. Accessed September 15, 2023. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8315858/#:~:text=Background%3A,decision%2Dmaking%20and%20drug%20prescribingLinks to an external site..