Sir William Osler, Functional Medicine Pioneer. You may be surprised to learn that Functional Medicine isn't new. It actually represents a return to the roots of modern scientific medicine, captured in this statement by Sir William Osler, one of the first professors at Johns Hopkins University School of Medicine and later its Physician-in-Chief: "The good physician treats the disease; the great physician treats the patient who has the disease." Another important saying by Osler is "If you listen carefully to the patient, they will tell you the diagnosis." This encapsulates the importance placed in Functional Medicine on taking a thorough history from the patient.
Functional Medicine uses two scientifically grounded principles:
1. Add what's lacking in the body to nudge its physiology back to a state of optimal functioning.
2. Remove anything that impedes the body from moving toward this optimal state of physiology.
Plainly put, your body naturally wants to be healthy. But things needed by the body to function at its best might be missing, or something might be standing in the way of its best functioning. Functional Medicine first identifies the factors responsible for the malfunctioning. Then it deals with those factors in a way appropriate to the patient's particular situation. Very often Functional Medicine practitioners use advanced laboratory testing to identify the root cause or causes of the patient's health problem. Old-fashioned medical diagnosis helps too, in the form of listening carefully to the patient's history of symptoms and asking questions about his or her activities and lifestyle. For treatment, Functional Medicine practitioners use a combination of natural agents (supplements, herbs, nutraceuticals and homeopathics), nutritional and lifestyle changes, spiritual/emotional counseling, and pharmaceuticals, if necessary to prod a patient's physiology back to an optimal state. In addition, educating the patient about their condition empowers them to take charge of their own health, ultimately leading to greater success in treatment.
Today's health care system is in trouble because it applies a medical management model that works well for acute health to chronic health problems where it is much less successful. If you have a heart attack, accident or sudden lung infection such as pneumonia, you certainly want a quick-thinking doctor to use all the quick-acting resources of modern medicine, such as life-saving technology, surgery and antibiotics. We are all grateful about such interventions. However, jumping in with drugs, surgery and other acute care treatments too often does not succeed in helping those with chronic, debilitating ailments, such as diabetes, heart disease or arthritis. Another approach is needed and that's where Functional Medicine fills the gap!
Functional Medicine is patient-centered medical healing at its best. Instead of looking at and treating health problems as isolated diseases, it treats individuals who may have bodily symptoms, imbalances and dysfunctions. As the following graphic of an iceberg shows, a named disease such as diabetes, cancer, or fibromyalgia might be visible above the surface, but according to Functional Medicine, the cause lies in the altered physiology below the surface. Almost always, the cause of the disease and its symptoms is an underlying dysfunction and/or an imbalance of bodily systems.
Named diseases are just the tip of the iceberg. Below the surface, according to Functional Medicine, are the real causes of a patient's health problems.
If health care treats just the tip of the iceberg, it rarely leads to long-term relief and vibrancy. Identifying and treating the underlying root cause or causes, as Functional Medicine does, has a much better chance to successfully resolve a patient's health challenge. Using scientific principles, advanced diagnostic testing and treatments other than drugs or surgery, Functional Medicine restores balance in the body's primary physiological processes. The goal: the patient's lifelong optimal health.
In the dominant health care model today, medication is used to get rid of people's symptoms. If the patient stops taking the medication, symptoms generally return. Functional Medicine approaches health problems differently. Instead of masking the problem, it aims at restoring the body's natural functioning. Although Functional Medicine practitioners may prescribe pharmaceuticals, they are used to gently nudge the patient's physiology in a positive direction so the patient will no longer need them. For example, conventional doctors would normally prescribe pharmaceuticals like Prilosec, Prevacid or Aciphex to treat acid reflux or heartburn. When the patient stops taking such drugs, the heartburn symptoms come back. In contrast, a Functional Medicine practitioner might find that a patient's acid reflux is caused by Helicobacter pylori bacteria. Eradicating the Helicobacter pylori might very well lead to the end of heartburn symptoms, permanently. It's also important to note that in Functional Medicine, treatment for similar symptoms might vary tremendously for different patients, according to their medical history and results of laboratory tests. Factors that can come into play in producing the same symptoms include toxic chemicals, pathogenic bacteria, parasites, chronic viral pathogens, emotional poisons like anger, greed or envy, and structural factors such as tumors or cysts.
We have titled this section "Medical Detective," because patients often feel their Functional Medicine practitioner is leaving no stone unturned in their relentless research to pinpoint the causes of a particular patient's symptoms. When you consult a Functional Medicine practitioner, the first step is always your history. Practitioners are trained on how to unravel and make sense of a complicated story. Often clues in the story lead to the identification of key imbalances. The next set of clues comes from a comprehensive physical examination, which includes many nearly forgotten examination procedures used by famous diagnosticians (both living and long gone), such as chapman reflex points, ankle brachial reflex and nail inspection. The final set of clues comes from advanced laboratory testing. Innovative, cutting-edge lab tests help the practitioner look deeply into a patient's physiology to identify how it has been compromised and how physiological balance can be restored. After diagnosis and treatment, a Functional Medicine patient can expect his or her symptoms to diminish in severity, with a renewed sense of well-being and significant increase in health and vitality. While there is no substitute for face-to-face treatment from a trained Functional Medicine practitioner, this site educates you on the Functional Medicine perspective and on the kinds of clues and treatments that may be key to restoring you to optimal health.
Functional Medicine offers a powerful new operating system and clinical model for assessment, treatment, and prevention of chronic disease to replace the outdated and ineffective acute-care models carried forward from the 20th century. Functional Medicine incorporates the latest in genetic science, systems biology, and understanding of how environmental and lifestyle factors influence the emergence and progression of disease. Functional Medicine enables physicians and other health professionals to practice proactive, predictive, personalized medicine and empowers patients to take an active role in their own health.
1. An understanding of the biochemical individuality of each human being, based on the concepts of genetic and environmental uniqueness;
2. Awareness of the evidence that supports a patient-centered rather than a disease-centered approach to treatment;
3. Search for a dynamic balance among the internal and external body, mind, and spirit;
4. Interconnections of internal physiological factors;
5. Identification of health as a positive vitality, not merely the absence of disease, and emphasizing those factors that encourage the enhancement of a vigorous physiology;
6. Promotion of organ reserve as the means to enhance the health span, not just the life span, of each patient.
A patient-centered approach refers to health care that is respectful of and responsive to individual patient preferences, needs, and values, and that ensures that patient values guide all clinical decisions. At CWI, patient-centered care is the core of what we call the therapeutic partnership; the relationship that forms between a patient and clinician that empowers the patient to take ownership of their own healing. The power of the therapeutic partnership comes from the idea that patients who are active participants in the development of their therapeutic plan feel more in control of their own well-being and are more likely to make sustained lifestyle changes to improve their health.
The illustration to the left, lets use a tree to visually represent the core aspects of the Functional Medicine paradigm and highlight the difference between conventional medical care and Functional Medicine. The tree itself has undergone many changes through the years, but its essence remains the same. In order to keep a tree healthy and allow it to flourish, you need to support the most basic and essential elements first; the foundation: the roots and soil. Similarly, if a tree is not healthy, the first place you should look for answers is those same foundational elements. In Functional Medicine, the same approach applies to patients.
The most important factors, and the ones we examine first when gathering information about the patient, are the foundational lifestyle factors; sleep, exercise, nutrition, stress levels, relationships, and genetics. These are the roots and soil, which are in turn influenced by specific predisposing factors (antecedents), discrete events (triggers), and ongoing physiological processes (mediators), and may then result in fundamental imbalances at the trunk. These can eventually result in the signs and symptoms that are grouped into a diagnosable constellation that we call disease, represented by the branches and leaves.
Conventional medicine tends to look at the constellation of symptoms first (the branches and leaves), which usually results in a disease diagnosis. Often, this diagnosis is associated with a drug or drugs that can be prescribed to treat this constellation of symptoms, and that is the end of the story. But this approach neglects the more fundamental aspects of health that reside in the roots and the trunk of the tree. It treats all patients that present with similar symptoms the same and completely neglects both the inherent differences among patients as well as the myriad possible causes that a "disease" can have. If you are tired of spending your time in the leaves and watching as your patients with chronic disease going through the cycle of diagnosis and drugs without getting any better, we invite you to climb down from the canopy and join us at ground level. We will use Functional Medicine, diagnose your disease and get you on your way to a healthier you!