Functional Medicine: A Little History
A large portion of the history of mankind is devoted to the endeavor to heal and promote healing. The issues address areas of injury, infection, and organ and systemic dysfunctions. Progress has been steady and, until recently, only occasionally marked by dramatic advance.
Medical Advances and Public Health
Dramatic advances in treatment and health maintenance started coming more frequently in the 20thCentury. We tend to think of lengthening longevity as the outcome of medical advances and this has certainly had an important role. However, public health has had a pivotal function as well and we will briefly review some of it.
What are some of the public health advances? Let’s limit our survey to three powerful examples.
- Indoor plumbing and sewage treatment. For most of human history, excrement has posed a serious health problem. Feces provide a dynamic vector for disease. In addition to carrying away our waste, indoor plumbing boosted our bathing habits
- Daily bathing. Hard as it may be to believe, Americans did not bathe regularly or frequently until after WWI, 1918. The health benefits of daily hygiene were known to science, but resisted by the public. During WWI, the Army required men to bathe daily to maintain unit health. The soldiers acquired the habit, brought it home and shared it with their families. Voila!
- The automobile? Technology generally has a part to play in advancing public health. The plumbing just mentioned was an example. While many people today have romantic notions of life using horses as primary transportation, the fact is that the mounds of horse manure on farms and the mountains of manure produced by cities presented enormous vectors for disease. As cars came into wider use, overall health improved. Some common infections, like tetanus, have become quite rare.
Conventional and Alternative Medical Delivery Systems
In late 20th Century America, health delivery became increasingly diversified. What came to be termed conventional treatment was joined by a variety of what have come to be known as alternative or complementary treatment systems. Predictably, this has led to confusion about what is what. Therefore, we will now define and explain these terms.
Functional Medicine addresses the underlying causes of disease, using a systems-oriented approach and engaging both patient and practitioner in a therapeutic partnership. It is an evolution in the practice of medicine that better addresses the healthcare needs of the 21st century. By shifting the traditional disease-centered focus of medical practice to a more patient-centered approach, Functional Medicine addresses the whole person, not just an isolated set of symptoms. Functional Medicine practitioners spend time with their patients, listening to their histories and looking at the interactions among genetic, environmental, and lifestyle factors that can influence long-term health and complex, chronic disease. In this way, Functional Medicine supports the unique expression of health and vitality for each individual.
How Functional Medicine Changes the Way We do Medicine
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 providers and other health professionals to practice proactive, predictive, personalized medicine and empowers patients to take an active role in their own health. Functional Medicine is a personalized, systems-oriented model that empowers patients and practitioners to achieve the highest expression of health by working in collaboration to address the underlying causes of disease.
How is Functional Medicine Different?
The illustration of a tree is used to represent the core aspects of the Functional Medicine paradigm and highlight the difference between conventional medical care and Functional Medicine. 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.
Functional Medicine and Conventional Medicine:
So how is Functional Medicine different from today’s conventional Western medical system? To begin, the focus of care is different. The goal of conventional medicine is for doctors to identify diseases by recognizing patterns of symptoms and to treat those symptoms by prescribing drug-based therapies that are similar for all patients with a given disease. Notice that the words patient and health do not appear in this description. The goal of Functional Medicine is to promote health and vitality in each patient. Practitioners examine each patient’s lifestyle and unique biochemical factors to identify the underlying causes of their disease and find treatments that help return patients to optimal health separates doctors based on their specialties (e.g., neurology, gynecology, and endocrinology), effectively arranging medical care into separate silos. Functional Medicine is holistic, in that one clinician looks at all aspects of the patient, instead of saying, “Oh, that sounds like a hormone problem. That’s not my department.” Functional Medicine is highly cost effective for patients, as it focuses on prevention and health promoting lifestyle changes and sustainable treatments that address the underlying causes of dysfunction, restoring patients to health. Conventional medical treatments are often expensive medications that must be taken indefinitely and do not address the underlying problem, but merely suppress the symptoms.
|Functional Medicine||Conventional Medicine|
|Health oriented||Disease oriented|
|Patient Centered||Doctor Centered|
|Biochemical Individuality||Everyone is treated the same|
|Underlying causes of disease||Diagnosis based on symptoms|
|Preventative Approach||Early detection of disease|
|High touch/high tech as needed||High tech|