The Future of Medicine is Functional

Why a new model of healthcare is the only way forward.

Most Americans would agree that our healthcare system is fractured. Not only is it a topic of heated political debate, it is a source of frustration, stress, and expense for consumers. When we interact with the healthcare system, we are generally in a vulnerable state, and the process of navigating between specialists, obtaining authorization for medications or medical imaging, undergoing procedures, and managing recovery is complicated and poorly coordinated. We also know that the United States doesn’t compare well to other countries when considering health outcomes relative to health care expenditure.

According to data compiled by The Commonwealth Fund of 13 high-income countries, the United States spends over 17% of its GDP on healthcare — about 50% higher than the next biggest spender, France. Despite higher spending, Americans have fewer annual hospital and physician visits compared to other nations, and the lowest life expectancy of all of the nations studied (78 years). The prevalence of chronic disease is also higher in the United States, with 68% of adults age 65 and older having at least two chronic conditions (other countries ranged from 33%-56%).

The reality is, our healthcare system is good for treating some conditions but not others, and those others are becoming increasingly important. At major medical centers, we have cutting-edge research, exceptionally trained clinicians, and specialty care services that are the best in the world. However, trends in population health change. At the beginning of the 20th century, infectious diseases such as pneumonia and tuberculosis were responsible for the highest number of mortalities. The result was a spur of innovation in pharmaceuticals, vaccinations, sanitation and hygiene, and antibiotics. The end of the 20th century and beginning of the 21st century, however, saw a drastic rise in death from chronic disease. In 2015, the leading causes of death were heart disease, cancer, and chronic lower respiratory diseases.

A recent study conducted at The Mayo Clinic revealed the top ten reasons that people visit their doctor: skin disorders, osteoarthritis and joint disorders, back problems, cholesterol problems, upper respiratory conditions (excluding asthma), anxiety/depression/bipolar disorder, chronic neurologic disorders, high blood pressure, headache and migraines, and diabetes.

In the face of these chronic health conditions, functional medicine has emerged as a promising alternative model to traditional care. It takes a systems approach to the health of an individual, and it partners the practitioner and patient in a collaborative mission to re-establish true balance and well-being. Instead of being a passive recipient of medical intervention, functional medicine empowers the individual to take ownership of his/her health trajectory and emphasizes preventative practices as well as curative treatments. Because chronic diseases arise from an interaction of multiple factors, the traditional medical model is inherently unable to effectively treat them. The following table compares attributes of functional medicine and conventional medicine:

From The Institute for Functional Medicine

A non-profit organization at the center of the functional medicine movement, The Institute for Functional Medicine (IFM) was founded in 1991 by Dr. Jeffrey Bland, an internationally renowned nutritional biochemist, scientist, and teacher in natural medicine. The IFM serves as a research and educational institution to further the study and practice of functional medicine.

Practitioners trained in functional medicine see the manifestation of disease symptoms in any organ as a result of complex, underlying imbalance in one or multiple systems. The expression of our genetic code is influenced from the time of our birth by mental, spiritual, and emotional factors as well as experiences, attitudes, and beliefs. Our lifestyles and environment also have important effects on our health trajectory. Over time, an individual may begin to show signs and symptoms of disease that indicate imbalance in one or more physiological system. The Functional Medicine Tree below illustrates how interconnecting variables affect our health:

From The Institute for Functional Medicine

In applying the functional medicine framework to disease, one recognizes that one condition may be the result of multiple imbalances, or one imbalance may result in multiple disease symptoms. To guide the therapeutic partnership between clinician and patient, functional medicine practitioners use the Functional Medicine Matrix:

From The Institute for Functional Medicine

Across specialty areas, clinicians are increasingly adopting functional medicine principles and forming multidisciplinary teams to more effectively treat and prevent the trajectory of chronic disease. Just a few of the leaders in this important healthcare movement are:

Chris Kresser, an internationally acclaimed expert in ancestral medicine, acupuncturist, nutritionist, and writer who founded The Kresser Institute to study and educate practitioners in functional and evolutionary medicine, and The California Center for Functional Medicine to treat patients with a variety of chronic conditions.
Dr. Aviva Romm, who is revolutionizing women’s health in New York City by addressing hormonal imbalances, pregnancy and childbirth, and other chronic conditions with natural methods.
Dr. Pedram Shojai, who founded of Well.org and is a leader in connecting Eastern and Western medical traditions, improving workplace wellness, and optimizing individual and environmental health.
Dr. Sara Gottfried, a renowned functional medicine writer and speaker who specializes in women’s gynecological and hormonal health.
Dr. Robin Berzin is the founder of Parsley Health, a comprehensive functional medicine practice in New York City that utilizes a membership model and recently expanded to Los Angeles and San Francisco.
Dr. Mark Hyman, who leads The Cleveland Clinic Center for Functional Medicine, a revolutionary partnership between the IFM and a major medical center designed to prove that the functional medicine model results in better health outcomes, cost savings, and fewer hospital readmissions for patients with chronic conditions.
James Maskell, who links practitioners, educational institutes, and technological advancements via Functional Forum and The Evolution of Medicine to advance the quality, application, and delivery of functional medicine healthcare.

Upgrading our healthcare system to meet the needs of our population is long overdue. We can no longer ignore the fact that we spend way too much on services that don’t effectively address the root causes of our chronic diseases. The functional medicine model of assessing and treating disease and optimizing systemic wellness makes logical and intuitive sense. Don’t wait to learn more about and engage in the future of medicine!


References:

Centers for Disease Control and Prevention. (2016 May). Health, United States, 2015. Retrieved from https://www.cdc.gov/nchs/data/hus/hus15.pdf#019

Centers for Disease Control and Prevention. (2016, November 14). Chronic disease prevention and health promotion. Retrieved from https://www.cdc.gov/chronicdisease/

Jones, D.S. & Quinn, S. (2016). Introduction to functional medicine. The Institute for Functional Medicine. Retrieved from https://p.widencdn.net/wzl55z/Intro_Functional_Medicine

St. Sauver et al. (2013). Why patients visit their doctors: assessing the most prevalent conditions in a defined American population. Mayo Clinic Proceedings, 88(1), pp. 56–67.

The Commonwealth Fund. Accessed April 2, 2017 at http://www.commonwealthfund.org.

The Institute for Functional Medicine. Accessed April 2, 2017 at https://www.functionalmedicine.org.