Is it possible to reverse chronic disease with a new approach to medicine?
Is this type of medicine better than conventional medicine?
Are there any downsides to this approach?
In this article, we are going to explore all of these topics while focusing on some of the downsides to functional medicine.
I make these comments as a practitioner of functional medicine based on both my experience and my experience in discussing patient experiences with other doctors and providers.
What is Functional Medicine?
Functional medicine is really best thought of as a new approach to treating patients.
This approach focuses on treating each patient holistically, as an individual, with a target on the underlying cause of disease.
Functional medicine has become popular recently as an approach to treating certain reversible chronic diseases which are typically poorly managed by conventional medicine.
This is because functional medicine, as an approach, focuses on the individual and attempts to provide therapies which work by reversing disease rather than covering up symptoms with medications.
I've been practicing my own version of personalized functional medicine for several years with great success.
But through my years in treating patients, I've also heard about their stories as they have been treated by various functional medicine providers.
And what I've found is that while functional medicine is a great tool, it also comes with some potential downsides.
And these downsides should be considered by you as the patient before you make an investment of time, money, and energy with a functional medicine provider.
#1. It's not covered by insurance (usually)
Even if we make the argument that functional medicine is the best type of medicine available, it doesn't really help if only a select few people are able to afford it.
And that's one of the biggest problems with functional medicine:
Functional medicine is not really recognized by most insurance companies so physicians can't bill insurance in the same way that they would for typical visits.
Things such as lab testing, imaging of the body, and sometimes supplements (1), can be covered by insurance even if the doctor visit isn't.
In addition, functional medicine consults tend to require much more personal time with the patient (this is a good thing) but this personal time cannot be billed for under current guidelines.
Given that this type of medicine requires more time and usually is not covered by insurance, most doctors do not accept insurance for functional medicine visits.
I'm a huge advocate for spending time and investing in your health but I also appreciate that this may not be possible for many of you out there.
This doesn't mean that functional medicine is bad but it does mean that we should try our best to allow for this type of health care to be disseminated to everyone.
It would be less than ideal if only certain people were able to afford this type of health care.
Having said all of this, the price of functional medicine practitioners may actually be comparable to seeing your conventional doctor after you take a closer look at the math.
You have to remember that the goal of functional medicine is to eliminate or reverse chronic disease.
If successful, this means that you can potentially go off of your medications (for good), may be more productive at work, and have a better quality of life.
And this all results in cost savings to you as the patient.
Take diabetes for instance:
On average, patients with diabetes spend an extra $16,752 per year (2).
If you can reverse your diabetes (type II) you will be able to save that money.
All of these things won't necessarily be seen financially but they are definitely worth something to each of you.
Furthermore, if you can get off of your existing medications and reverse conditions such as high blood pressure, high cholesterol, obesity, and so on, this will have a massive positive effect on your long-term health and your risk of developing debilitating diseases later.
This will obviously result in savings you would have otherwise paid in both insurance premiums and health care in general.
Also, if you can eliminate these high-risk conditions (which most are reversible, by the way) you can switch to a high deductible insurance plan (only for emergencies) and save even more money by reducing insurance costs and savings with vehicles such as an HSA (3).
You should consider all of these factors before you take the plunge but just realize that there are many variables involved.
#2. It can be difficult to find a practitioner
Another big downside is that this type of medicine is not available to everyone.
Unfortunately, functional medicine is not a well-known specialty at this time which means that not all doctors may even be aware of this type of approach.
This means that it may be difficult for you to find a physician, especially if you live in a small town.
I've had numerous people reach out to me to tell me that they are willing to travel just for treatment.
And these individuals come from all over the United States and even outside of the United States.
This suggests to me that we may have a supply problem.
For this reason, it's a good idea to at least introduce your doctor to the concept of functional medicine.
It's possible that they may not even be aware of the holistic approach of functional medicine and would love to learn more if they are made aware.
On the flip side, you also need to be aware that many physicians might reject the idea of a new approach to medicine.
#3. The training is not standardized
What do I mean by standardized care?
To understand this concept we need to compare functional medicine to conventional medicine.
Conventional medicine would be the approach which all doctors are trained in and this is taught in both medical school and residency.
This type of training is consistent regardless of where you go to residency, which state you are being trained in, or which hospital you are at.
The training for things like cancer treatment, thyroid management, blood pressure management, and so on will all be the same.
This is great if you are a patient living in Oklahoma and you have to go to your doctor for some sort of cancer treatment.
You can be confident in knowing that the therapies your doctor is using will be the same regardless of the state that you live in.
This is what is meant by standardized training. Everyone gets the same training.
This has both pros and cons.
One of the biggest pros is that you can get consistent quality care wherever you are.
One of the biggest cons is that the care is ALWAYS the same whether or not it's the "best".
Take thyroid management, for instance.
It's great that the way that primary care physicians and endocrinologists treat is very similar.
But it's also a bad thing, in this setting, because the current treatment paradigm leaves a lot of undertreated and unhappy patients.
So, let's take this concept and apply it back to functional medicine for a second.
Functional medicine training is not yet standardized.
There are only a handful of training institutions and the training among those institutions is not exactly the same.
In addition, because board certification is not required to practice functional medicine, there may be a big difference in the quality of care you receive from various functional medicine practitioners.
Just going to a functional medicine doctor doesn't mean that you are getting good care.
You may be going to an inexperienced physician or someone who hasn't completed their training yet.
This may lead you to falsely believe that you are getting the best care when you aren't.
And, currently, there is nothing to stop providers from claiming that they practice functional medicine even if they have not completed training.
I'm not suggesting that this is a bad thing or that it needs to be changed but it's definitely something that you should be aware of as a patient.
It can also be bad for the profession if you go to an inexperienced practitioner, have a bad experience, and then extrapolate that experience onto the whole of functional medicine.
This is a disservice to providers that are actually skilled at their profession.
The skill differential in a beginner from an expert is seen in all types of jobs ranging from teaching to plumbing and everything in between.
It even exists with standard physicians but it's hidden due to the long length of training required.
You can't go out and practice as a young doctor until you've finished residency.
This ensures that all doctors who complete residency leave with a certain level of skill and knowledge (4).
There will always be variations in skill but you can almost guarantee at least some baseline level of competence with this approach.
#4. Not all functional medicine practitioners can prescribe medications
As a physician, this one is particularly important to me.
There are many types of providers and practitioners who can label themselves as functional medicine practitioners but not all of these providers can prescribe medications.
You might not think this is a big deal if you are attempting to take a more "natural" approach to your therapies.
The fact is that it still matters, quite a bit.
There are many prescription medications which can be used to help augment therapies and help reverse chronic conditions.
These medications can only be prescribed by certain providers such as MD's, DO's, FNP's, PA's, and some ND's (depending on the state).
Practitioners such as chiropractors (DC's) and health coaches are not able to prescribe medications regardless of the state that they are practicing in.
Even if you don't want medications, though, you still may want someone who understands medications to treat you.
Many of you reading this, according to the most recent statistics (5), are taking prescription medications.
If your goal is to potentially get off of those medications you need to have physician supervision to stop them.
It can be dangerous to potentially stop taking certain medications cold turkey and may result in unwanted or negative symptoms (6).
Finding a functional medicine physician who can prescribe medications can help you use the right types of medications and also help you reduce or titrate off of your existing prescription medications.
I'm not trying to suggest that certain practitioners are automatically better functional medicine providers just because they can prescribe medications, on the contrary.
I've met many MD's and DO's who are less competent at functional medicine when compared to other providers who can't prescribe medications.
But, if you have your choice, it would be best to find a provider who is both competent in functional medicine and who can also prescribe (or help you get off of your medications if that is your goal).
#5. It's used as a marketing tactic
More and more I see the term functional medicine thrown around as more of a marketing tactic than a philosophy used to treat patients.
This is particularly concerning because it diminishes the value of functional medicine and can lead to sub-par results.
It can be difficult to tell which of the providers are serious about using functional medicine and which providers are using it as a marketing tactic to get more patients.
My best advice to you as a patient is to seek out providers who have reviews online that you can read from.
Better yet, if you can find someone via word of mouth who has used a certain physician or provider and had a positive experience then use that source.
Avoid providers who use modern-day marketing tactics (facebook/instagram advertising, google ads, and so on) and focus more on making unsubstantiated medical claims or promises.
As a general rule, if something sounds too good to be true then it probably is.
I have seen some miraculous recoveries and results in many patients that I have treated.
But these results tend to be the exception, not the rule.
I would also never promise those results to everyone no matter how confident I was.
You can use resources such as this one to help you find local functional medicine providers.
#6. Some practitioners have an aversion to prescription medication
Some people equate functional medicine with a purely natural approach to healthcare.
This approach, to some people, means that you must use only natural therapies to treat ailments.
Therapies which fall into this category include supplements, dietary changes, exercise routines, and so on.
It necessarily removes the use of certain prescription medications.
Some doctors and some patients believe that all prescription medications are negative or harmful simply because they are prescriptions.
But this isn't true at all.
Many types of prescription medications contain actual bio-identical hormones. The same hormones that your body produces naturally!
Yes, they require a physician prescription, but they are an exact replica of the hormones that your body produces on its own.
These types of medications are not necessarily harmful just because they require a prescription.
As an example, let's consider a situation of high blood pressure.
Let's imagine that you are someone with high blood pressure and you are currently taking some prescription medication to treat the issue.
Instead of using that prescription medication you want to try and treat it naturally so you go to your functional medicine provider.
This provider takes you off of your medication and places you on a dietary supplement (7) to treat your blood pressure.
Your blood pressure drops slightly but not to the level that it was on your prescription medication.
You are not thrilled with the results but you are happy to be off of your medication.
Is this actually a good situation to be in? Are you better off then when you started?
I would argue it isn't.
Because the goal of functional medicine is to try and find the root cause of a disease process and treat/reverse that problem.
Taking a prescription medication is simply a cover up to that problem.
But isn't this the same approach which is taken with some dietary supplements?
Aren't some supplement simply acting in the same way that a medication would if they only temporarily solve the issue you are trying to treat?
Unless you are targeting the underlying cause of high blood pressure, such as insulin resistance (8) or weight gain, you aren't doing a service to the patient.
I see this sort of approach taken frequently among physicians practicing functional medicine which is really just a conventional medicine mindset with supplemental therapies.
Real functional medicine is personalized and attempts to treat or reverse the underlying cause of conditions.
And, sometimes this can be done with prescription medications and sometimes it can be done without them.
But the point is you don't want to eliminate the potential use of all medications because many can be helpful.
If you throw them all out you are throwing the baby out with the bathwater.
Should you seek out a functional medicine provider?
I hope as you read this that you don't get the impression that I am suggesting that you should not see a functional medicine provider.
Because that's not the point I am trying to convey.
Instead, I am suggesting that not all functional medicine providers are created equal and that you might not get the quality of care that you are expecting unless you go to the right person.
In addition, I also want to point out that this type of medicine is not without its flaws.
But what about the pros?
In my personal opinion, the pros, if you go to the right type of provider, should outweigh these negatives.
The pros include potentially reversing chronic medical conditions that conventional medicine just doesn't have good treatments for.
It could also mean getting back your life or dramatically improving the quality of life by taking a new or fresh approach to your treatment.
A functional medicine practitioner is not a replacement for conventional medicine.
It's a better source of treatment for chronic debilitating conditions such as metabolic syndrome, insulin resistance, type II diabetes, autoimmune disease, hormone management, and so on.
But it's not a replacement for standard medical care or emergency medical care.
Conventional medicine plays an important role in healthcare and we shouldn't diminish the value of that role.
So, should you see a functional medicine provider?
The answer is that it depends.
But if you live in a place where one is local to you, if you can find someone with good reviews, if you can find the right type of provider, and if the price is reasonable, then it will probably be worth the investment.
On a more personal note, I would absolutely recommend that thyroid patients go to see a functional medicine provider.
This is because conventional thyroid management is very algorithmic and the functional medicine approach tends to be much better for this patient population.
Even though I've been critical of functional medicine I still think it plays an important role in our health care system.
Before you jump into a doctor-patient relationship with a functional medicine provider be sure to read through this article thoroughly.
By doing so you will ensure that you've taken the proper steps and that you know what you should be looking for (and what you should be avoiding).
But now I'd like to hear from you and get your comments on this topic:
Have you been seen by a functional medicine practitioner?
What kind of results are you getting?
Would you recommend that other people do the same?
Which provider/doctor are you using? If you like them please feel free to leave their information below for others.
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