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Jan 29, 2019

What Is Functional Medicine & What Do Functional Medicine Doctors Do?

by Dr. Dan Kalish

In the early 1990's I attended my first Functional Medicine seminar. In those years there would be 100-200 practitioners in a class, always taught by the field's founder, Dr. Jeffrey Bland. Dr. Bland would lecture for a full day, sometimes two, seemingly inexhaustibly and we'd be inspired to carry on the work.  His work was really the centerpoint for what has become an entire field of alternative medicine.

In those years if you had a room of 100 practitioners in attendance there would be 90 chiropractors, a few naturopaths and a couple of conventional physicians, along with the odd acupuncturists. (Not odd looking, I mean odd as in random) Now, 25 years later, the training programs I attend are mostly attended by MD's. It's an interesting shift over the last generation from a "fringe" field practiced by "alternative providers" to a movement led by physicians with conventional medical training. All this to say the acceptance of Functional Medicine is growing.

From those very early seminars to the current leading educational group, The Institute For Functional Medicine, the meaning of Functional Medicine has remained the same.

What Is Functional Medicine - Definition?

So what is it? What is Functional Medicine. My definition is "a lab based system of analysis that relies primarily on natural health solutions". We use science to determine the problems, i.e. lab work and focus on natural health treatments that are timeless, diet, meditation, exercise and oftentimes nutritional supplements, herbal treatments all based on labs. The meaning of the "Functional" part is that in Functional Medicine we strive to find organ "Dysfunction" prior to the onset of a disease process and restore "Function" back. I suppose you could call it "Dysfunctional Medicine" but that doesn't have a good ring to it!

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What is a Functional Medicine Doctor & Practitioner?

A Functional Medicine doctor restores normal physiology and normal body "Function" rather than focusing on the treatment of specific diseases. We find, in general, that if we can restore normal body function that most disease processes clear up. So then, what is a Functional Medicine practitioner? Ok, that question takes some explaining.

In a sense Functional Medicine is a area of specialty unto itself. So you could have a medical doctor that practices medicine, internal medicine or geriatric medicine, pediatric medicine or oncology AND practices Functional Medicine also. You could have a nurse practitioner or chiropractor or acupuncturist or naturopath that practices nursing, chiropractic, acupuncture or naturopathy AND alongside that practices Functional Medicine. You'll have some physicians that only practice Functional Medicine and cease to use their original training. Most docs combine whatever their original training was with the Functional Medicine model.

What do Functional Medicine doctors do in terms of initial workups?

Most follow a similar path. There is an initial new patient consultation, typically an hour or longer where they take a complete history, not just a medical history but a history of your life stresses, working to find the original underlying cause of the health problems you are experiencing rather than solely focusing on your current symptoms. All Functional Medicine doctors will order various types of labs, some used in conventional medicine but most unique to our field. Specialized GI assessments for your microbiome, measuring nutrient levels, amino acid levels, organic acids for brain health the liver detoxification pathways. SNP testing or genetic testing is common as is food allergy testing along with a variety of hormone assays. Schedule a 15-Minute Phone Consultation

Use of specialized Functional Medicine labs

What does a Functional Medicine doctor do with all these specialized labs in terms of treatments? We recommend lifestyle changes, which are pretty basic, it's everything you learned in kindergarten for adults basically. Get to bed early, eat your vegetables, get outside and play (i.e. exercise) and be nice to other people. That part is not rocket science. The rocket science part is the interpretation of the lab work and the development of health programs or health protocols based on the testing. That skill of lab analysis takes years to master.

This is the area where Functional Medicine really stands out because the labs often reveal hidden problems that have plagued the person for decades. Chronic low grade GI infections or pathogens that have disturbed the microbiome. An imbalance in the microbiome itself can be devastating and is instantly recognizable from the labs using PCR or DNA technology to map out your gut bacteria. Toxins such as mercury, lead and arsenic in general are not so friendly to the human brain and can be detected in a complete lab work up. The metabolites, or breakdown products of neurotransmitters such as serotonin or dopamine give insight into brain function and salivary hormone measurements for cortisol reveal the stress hormone system's state of function. The list goes on.

How to Find the Best Functional Medicine Practitioner

One problem with figuring out how to get the right Functional Medicine doctor is that as of now there is no official single body that licenses all Functional Medicine doctors as there are licensing bodies for many sub specialties in medicine. For example if you're seeing an ophthalmologist you can be pretty sure they've had advanced training in what's up with your eyes, a psychiatrist completes medical school and then studies mental health and so on. And since there are many different types of practitioners doing this work, MD's, DO's, DC's, ND's, LAc's, NP's, etc. it gets even more confusing to figure out who is or isn't trained in Functional Medicine because each of those groups has completely different state boards and different advanced degrees or specialization certificate programs. For now, the best, really the only, Functional Medicine academic/research oriented training program for physicians is The Institute For Functional Medicine. Their certified practitioners have the most complete and rigorous training available.

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And to answer the question what do Functional Medicine doctors do in a more esoteric way... They focus on the individual not the disease. They take your spiritual and emotional life seriously and understand your physical health depends on spiritual connection and emotional connection. They think what you eat every day can make you sick and conversely, what you eat every day can make you healthy. They think meditation is awesome. They think exercise is required. They believe in the restorative value of sleep. They won't think you're crazy if you are depressed or tired but all your standard medical tests are fine. They love the concept of healing without first turning to drugs and surgery yet are unafraid to use drugs or surgery if absolutely no other options exist. They care about the planet and take environmental toxin/environmental pollution very seriously as a health threat. They are here, on this planet, to be of service. To help people. We're the cool doctors!

To learn more about becoming a Functional Medicine practitioner, please see our full range of available training courses available to you!

A couple months ago I was teaching at a Functional Medicine conference and had the great good fortune to be sitting at a table with 8 or 9 other faculty. Looking around that table I realized each of these doctors is the kind of doctor I wish I had been able to find when I was younger. Someone that would listen before rushing to judgement, someone with highly developed clinical skills and critical thinking skills coupled with compassion empathy and that  healing touch that only a few people are granted.

Functional Medicine is a calling and by that I mean one is called to this line of work and we are "in service" to patients, not here to enrich ourselves or for our own ego gratification. As a group all the Functional Medicine doctors I hang out with are leading a revolution in health care, bringing back some sanity to our medical system by treating patients as people.

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Dr. Dan Kalish

Dr. Dan Kalish

Founder of the Kalish Institute
Dan Kalish, DC, IFMCP, is founder of the Kalish Institute, an online practice implementation training program dedicated to building Integrative and Functional Medicine practices through clinical and business courses.