Modern medicine is in crisis. The reason: it’s just not working.
Chronic diseases such as diabetes, heart disease, cancer, arthritis, obesity, and allergies are increasing with no letup in sight and account for seven of the top ten causes of death as of 2010. Heart disease and cancer accounted for forty eight percent of all deaths. Modern medicine may be great at dealing with infectious disease and traumatic injuries, but has failed to stem the tide of chronic disease.
In addition, surveys indicate that two-thirds of patients feel disrespected by their physicians, forty-four percent feel doctors don’t spend enough time with them and a quarter believe physicians don’t answer questions and don’t adequately involve them in treatment decisions, and use medical terms with no explanation.
Numerous health systems have gained prominence in the West as alternatives to what is known as mainstream or biomedicine. Naturopathy, Homeopathy, Ayurveda, Chiropractic, Chinese medicine, Acupuncture, Massage Therapy and Reiki have arisen as popular alternative healing methods. The most recent National Health Interview Survey estimates that up to forty percent of Americans have tried one or more of these alternatives and are spending $34 billion annually on them.
Reform From Within
Change is also occurring within the medical profession itself. Functional Medicine (FM) is a relatively new approach that has arisen from within mainstream medicine and challenges its reductionism and method of care. FM is not an alternative to biomedicine. Rather, it is a reform movement that is calling for a paradigm shift toward a holistic model of disease prevention and treatment based on the new scientific field ofsystems biology. Systems biology holds that the sum is greater than its parts. Living organisms are complex, whole and interactive systems and not a conglomeration of separate parts. Systems biology provides an elegant and accurate understanding of who we are and how chronic disease needs to be treated and prevented. FM embraces this position.
What is Functional Medicine?
The idea of FM was created in 1990 by Dr. Jeffrey Bland, known as the father of FM, to meet the growing challenge of chronic diseases with advances in modern medical science and systems biology. In 1991, he and his wife Susan created the Institute of Functional Medicine (IFM) to implement FM within the health care sector of society.
FM addresses the underlying causes of disease, not only its symptoms as mainstream medicine is prone to do. FM is a clinical application of systems biology that sees each person as an integration of mind, body and environment, a bio/psycho/social entity, if you will. FM is health rather than illness oriented. It treats the whole person and seeks to establish a dynamic equilibrium and resilience within each patient. In this way, it is holistic. A primary goal of FM is to promote each patient’s health and vitality. An FM practitioner is a medical doctor with special training through the FMI and typically looks at each patient’s:
- Personal lifestyle
- Unique biochemistry
- Genetic predispositions
- Environmental factors and toxicities
In the FM model, a disease may have multiple causes that include: sedentary and indoor lifestyle, chronic stress, genetics, poverty and lack of medical insurance, aging, fragmented families and community dysfunction, environmental toxicities, and nutritional deficiencies.
Regina Druz, MD, a practicing integrative cardiologist and FM practitioner in Mineola, NY, describes FM in very practical terms: “FM is root cause medicine. It relates disease symptoms and conditions to biochemical and genetic processes that govern states of health and disease.”
Practitioners often use the analogy of a tree and its roots to describe the FM model:
The roots of the tree are the multiple causes out of which grow the myriad chronic diseases that are now at epidemic proportions. Mainstream medicine treats the leaves (symptoms) whereas FM treats the roots (causes). See the full comparison here.
FUNCTIONAL MEDICINE is the future of conventional medicine–available now. It seeks to identify and address the root causes of disease, and views the body as one integrated system, not a collection of independent organs divided up by medical specialties. It treats the whole system, not just the symptoms.
Dr. Hyman’s video offers a clear explanation of the differences between functional and conventional medicine.
As stated by the IFM:
A major premise of Functional Medicine is that, with science, clinical wisdom, and innovative tools, we can identify many of the underlying causes of chronic disease and intervene to remediate the clinical imbalances, even before overt disease is present.
Emphasis is placed on ascertaining individual biochemistry, lifestyle factors, toxicology, using advanced laboratory and genetic testing coupled with treatment plans of diet, exercise, herbal treatments, supplements, detoxification, stress management, and appropriate use of pharmaceuticals.
Since disease prevention is a high priority for FM, efforts are made to partner with individuals and communities to advocate for social change. As Dr. Druz explains: “Public health plays a prominent role in the Functional Medicine domain as it focuses on prevention and early intervention of chronic diseases.”
The systems approach highlights the social origins of disease and demands moving beyond a purely in-the-clinic model and advocates for changes in such things as food policy (GMOs, industrial food production, etc.), poverty, and environmental degradation while supporting stable families. To be an effective medicine for the 21st century “Future clinicians, if they are to be integrative healers, need to be out where the people are and to participate in social and environmental policy change.”
The FM Treatment Plan
Forging bonds with individual patents entails FM practitioners spend much more time with patients than conventional physicians. It is typical to take a full patient history while including the patient in determining treatment options. The GOTOIT approach is fundamental to accomplishing this. Jones and Quinn identify the GOTOIT process as a logical way of “eliciting the patent’s whole story and ensuring that assessment and treatment are in accord with that story.”
G = Gather Information
O = Organize Information
T = Tell the Complete Story Back to the Patient
O = Order and Prioritize
I = Initiate Treatment
T = Track Outcomes
The FM practitioner enters all of this information into a Functional Medicine Matrix which allows for all pertinent info to be followed and changed as need be over time. This process demands consistent interaction between patient and physician.
Many in the field of FM believe it is the future of medicine. Regina Druz asserts that FM “…is the way of the future. My prediction is that we will come to full force within the next 5-10 years.” She adds that FM will allow the “…prevention of chronic disease and cancer to start in-utero and continue throughout one’s lifetime…Our children and grandchildren will be the beneficiaries.” Druz believes this is possible as genomics, epigenetics, toxicology and biochemistry expand our capacities to understand how the body/mind works and contemplate new clinical interventions.