Can Functional Medicine Improve Chronic Patient Experience?

We’ve been taking a closer look at many elements of healthcare and the patient experience, and one of the most important discussions focuses on the experience of patients dealing with chronic issues. After all, those who utilize a system repeatedly may be more likely to be faced with challenges along the way. If “dysfunctional medicine” is a problem, is “functional medicine” a possible answer?

What is functional medicine?

Functional medicine is a system of patient/physician collaboration that attempts to get to the crux of the ailment to develop a long-term remedy and promote well-being. It centers itself on biology-based principles. The Institute for Functional Medicine (IFM) explains that patients’ progress depends on full transparency of their genetic, biochemical, and lifestyle frameworks, thus creating the foundation for a customized treatment plan leading to improved outcomes. Indeed, this school of medical practice is not a fringe movement but a primary aspect of modern healthcare models and the focus of clinical research in many quarters.

To get a handle on the difference between traditional and functional/integrated medical practices, the latter drives a defined line to the root cause of disease, placing light, if not zero, weight on the symptoms. However, it hangs on the belief that some patient conditions connect to perhaps more than one cause. Moreover, it gets even more complicated on the premise that the same disease impacts people differently with varied symptoms, meaning that there’s no such thing as “a one size fits all” solution. So, the IFM website impresses on its audience that “functional medicine treatment targets the specific manifestations of disease in each individual.”

Who or what are functional medicine practitioners?

To become a functional medicine practitioner commonly requires IFM recognition via its official certification, involving intensive education and passing an exam. So, although functional medicine is realistically an independent healthcare field currently outside the realm of mainstream practitioners, every IFM-certified practitioner must already possess a recognized state or national license on its list (converging mainly on the 209,000 primary care physicians). Latest estimates put functional followers at 19% of the group, or 40,000 who practice it alongside their conventional strategies. While this proportion may appear relatively small, the evidence indicates accelerating growth over ten years. Here are some mind-boggling statistics from the same source:

• Nurse engagement in functional medicine has ballooned by over 200% in six years.
• During COVID-19’s social distancing protocols, IFM online training reached around 3,500 practitioners.
• Traction was real, evidenced by livestream registrations growing by nearly 75% in the year immediately before the epidemic (i.e., 2019 to 2020).

So what’s driving the increase in functional medicine practitioners?

The short answer is chronic disease. That’s according to Integrated Connection’s leader and founder, Lisa McDonald, who is at the center of practice growth resources and medical career development. In her view, traditional medicine isn’t coping with the demands of chronic sufferers, much of it due to the COVID long haul syndrome. To add substance to her position, the Atlanta-based Centers for Disease Control and Prevention estimates that 60% of American citizens and residents suffer from a chronic problem, and 40% experience more than one. For clarity, chronic disease is a state of severe discomfort lasting for a year or more.

Lisa’s career as an HR consultant in the healthcare industry exposed to the significant traction functional medicine is gaining. She believes the proliferation of private practices dedicated solely to functional medicine is off the charts already, estimating a significant boost in the future.

The bottom line is that, so far, traditional healthcare entities are doing a miserable job of treating chronic diseases. Why? Because family general practitioners (GPs) are not keeping up with new methods of preventive care and counteracting complex root causes of illness. The pandemic changed so many things, and patients have zero tolerance for the “same old, same old.” They want something groundbreaking to help people avoid oncoming disruptions to their lifestyle experience. In a nutshell, integrative and functional medicine practices appear to be the go-to long-term remedy.

Local nurse practitioner Serena Kumar, ANP-BC, IFMCP, who founded Avanti Hormones and Functional Medicine in Woodstock, is onboard with Lisa McDonald’s thinking. She confirms that from her vantage point, functional medicine has the power to close numerous chronic ailment gaps. Furthermore, she’s convinced that functional medicine growth owes its upward trajectory to patients wanting to participate in the cures. According to her, they want “to take control of their lives, not looking for not just a temporary ‘band-aid.’ They want to get to the root of their problems and to feel well again.”

Yoon Hang Kim, MD, MPH, medical director for Integrative Medicine at WellMed, maintains that he’s dealing with patients, for the most part, running out of conventional resources and solutions. Although he’s part of a minority, the latter is growing in leaps and bounds, making a huge impression because it understands functional medicine’s comprehensive approach and believes passionately in it.

Traditional medicine vs. Integrative medicine vs. Functional medicine in a nutshell

1. Conventional medicine focuses on symptoms as clues to the diseases that cause them. It relies on the premise that no matter who displays the symptoms, they all share the same condition. So, connect the symptoms to the diseases, construct a medicinal or interventional or both remedy, and it should solve all sufferers’ problems in the defined condition category.
2. Functional medicine and integrative medicine both deviate from the conventional approach. As a result, working out what methods are integrative or functional is often a head-scratcher. They’re both alternative and intermittently deploy techniques that conventionalists criticize as “unproven.” And in that assertion, they’re correct. Notwithstanding, in the light of conventional medicine’s inability to solve chronic suffering, these methods may eventually gain widespread recognition.
3. So talking more specifically, an integrative practitioner believes that chronic disease arises from numerous internal causes making up the “whole” of a person’s existence. They refuse to discount anything, including depression, low tolerance for stress, and physical deficiencies due to poor nutrition (sharing common ground with functional practitioners in all these factors.) However, they even get into spiritual beliefs and motivations. Indeed, as they see it, chronic disease boils down to one’s integrative health, driven by essential parts of our body working in a disjointed manner. The idea is to bring balance into the equation to dispel the disruptive aspects and capitalize on the ones creating the most health benefits.
   • So, here are the fundamental ingredients of an integrative approach that overlap with functional medicine:
     • The ones mentioned above.
     • The patient and practitioner participate in the decision-making and the process.
     • Everything converges on the individual’s unique needs to encourage the body’s natural, innate healing responses.
     • There’s a leaning toward more natural remedies.
   • However, here’s where integrative medicine moves into its own space:
     • No therapy is out of bounds, including conventional medications, acupuncture, massages, chiropractic methods, psychology, and homeopathy.
     • It will consider invasive interventions in extreme circumstances.
     • Practitioners in integrative medicine take the meaning of “individual’s unique needs” to extremes, including mental disorders, social affiliations, religion, and abnormal lifestyle circumstances.
4. The functional medicine approach goes straight towards uncovering the causes behind the illness. The first things they look for are genetic predispositions and environmental influences. Thus, it relies heavily on special testing to determine if the chronic ailment is original to the sufferer or as a result of previous misguided treatment. Circles within circles, that’s how complicated it can get. This process doesn’t go as broadly into a person’s overall framework as integrative practitioners do but touches on most of them. The idea is to solve a very complex puzzle. Practitioners in this vertical ask:
   • First, are many anatomical causes at the root of the sufferer’s condition? For example – the condition is depression. Therefore, is the latter a result of, say, Vitamin D deficiency, a low thyroid condition, current medications, etc.,
   • Second, and alternatively, is depression one of a series of simultaneous conditions like heart disease and possibly diabetes? In other words, are all the latter linked to a single cause like genetics or inflammation of a vital body part?
   • Either way, everything channels through a structured system that eventually changes one’s lifestyle. Things like stopping smoking, changing diets, drinking less coffee, altering sleeping schedules, cutting out certain medicines, and initiating exercise regimens emerge regularly. Alternative treatments enter the mix. However, as soon as traditional methods enter the conversation, we’re breaking into the integrative medicine arena. So, the following describes the functional medicine process:
     • Gather the information
     • Develop rapport with patients
     • Organize information and insights
     • Identify unhealthy patterns
     • Create a program based on the data:
       • Define the problem root cause – customize input – structure lifestyle coaching
     • Initiate the steps to be taken
     • Track progress

More on functional medicine as mainstream enough for people to trust it

Massive healthcare and primary doctor practices nationwide have adopted functional medicine since 2012. For example, the Cleveland Clinic introduced its Functional Medicine Clinic eight years ago, stating that the field “is the future of medicine.” Moreover, the clinic has escalated its functional medicine footprint by broadening services and establishing research trials to investigate how this innovative approach can impact a variety of illnesses and conditions.

Kumar’s passion for this healthcare vertical translates into the “whole person” concept – moving decisively away from narrowly focusing on symptoms (as her traditional training dictates). For example, a patient with alopecia (hair loss) traditionally demands the doctor spend time examining the scalp, followed by prescribing a hair growth medication. Instead, Kumar covers a range of factors that possibly lead to the hair loss condition, such as:

• Vital vitamins and mineral deficiencies
• Endocrine (thyroid) dysfunction
• Diet
• Emotional stress
• Sleep habits
• Genetics
• Dermatological issues and allergies.

Of course, the medication in the conventional channel may indeed be the answer to the problem, but it must emerge from a more comprehensive study. In other words, functional medicine doesn’t replace traditional diagnosis. Instead, it feeds it with new energy, expanding its horizons to close all possible gaps. As a result, the patient experience is significantly more rewarding on many lifestyle levels, unearthing disruptive touchpoints that conventional strategies bypass.

Dr. Rob Downey, IFMCP and founder of Seaworthy Functional Medicine, a South Peninsula Hospital in Alaska department, confirms that Kumar’s transition is relevant to the times and the future. He says, “(Functional medicine) opens radical new domains of how to understand the root causes of chronic problems.” He adds that emerging out-of-the-box thinking results in surprising outcomes that conventional medicine cannot contemplate. He summarized by saying, “Functional medicine patients simply do better, whether they experience reversal of their conditions or a more satisfying disease management plan.”

The way Dr. Downey sees it, medications and surgical invasions should be the last resort, not the front-line attack in a professional’s armory. In other words, use common sense to uncover root causes even though the aligned methods aren’t validated scientifically. As long as the latter category is safe, it can significantly impact fast, positive clinical outcomes.

Functional medicine career opportunities are opening up every day

Kumar and McDonald agree that the functional medicine model of care fits nursing like a hand in a glove. Additionally, nurse practitioners represent a high-demand service in healthcare with extraordinary entrepreneurial flair, opening practices up and down the US. Their pivotal role in the expansion of functional medicine cannot be underestimated.

It goes further, overlapping the strategies of physicians, their assistants, chiropractors, registered dietitians, physical and occupational therapists, and naturopathic doctors. All these professions are eligible to practice functional medicine. The IFM practitioners eligible for certification list also embraces dentists, acupuncturists, optometrists, podiatrists, and more.

Available mentorship programs

Medical schools offer functional and integrative medicine courses as interest in the field escalates. According to an IFM spokesperson, student and resident growth over two years (2019 – 2020) grew by 45% and is still escalating. The options to learn more about functional medicine include multiple internet sources with Google searches, leading to podcasts, articles, and even free trial courses to “test the temperature.” There’s also the possibility of joining mentorship programs offered by professional associations and participating in virtual educational programs under experts from all corners of the world. The ones we suggest connecting to are:

• The Institute for Functional Medicine
• University of Arizona’s Andrew Weil Center for Integrative Medicine
• Academy of Integrative Health & Medicine
• American Academy of Antiaging Medicine
• Personalized Lifestyle Medicine Institute
• American College of Lifestyle Medicine

For individuals with robust medical training, springboarding into functional medicine is relatively seamless and a natural extension. Building a passion for the disciplines and the revelations they generate won’t take long once you get into it.