Big Medicine goes Functional

Today modern medicine stands on the brink of wonderful things. A cure for cancer and other chronic degenerative diseases is finally in sight as genetic science increasingly provides the answers to many of the conditions that currently blight our lives - but don’t hold your breath and, more to the point, will you be able to afford the new Planet Medicine when it does arrive? Meantime we need to look after ourselves…

Genetic breakthrough coming thick and fast is great news, of course. Unfortunately it will be another ten years or so before the New Medicine kicks in. Even then, will you and I be able to afford it when it does? What do you reckon will be your insurance premiums ten years on, I wonder? Someone’s got to pay for it all, and we pretty much know who that’s going to be.

Best not get sick.

I don’t joke. We need to protect ourselves and the best way of doing that is by not getting sick if we can possibly avoid it. The bad news is that more and more of us are suffering from complex, chronic diseases such as diabetes, heart disease, cancer, dementia and mental illness, along with autoimmune diseases such as rheumatoid arthritis. These conditions are life style or wear and tear diseases, which means they can be delayed or even avoided if we knew how.

The conditions listed do not necessarily kill us outright and modern medicine as currently practiced is marvelously skilled at keeping us alive – particularly if we can afford it. That’s good… so far as it goes but it would be a lot greater if it could actually cure us of these chronic degenerative conditions rather that presiding over an expensive and downward slope of hospitalization and medication into disability and penury.

The practice of medicine today is not going to be much help to us in preventing this, scenario, rigged as it is toward acute care. That is to say the diagnosis and treatment of trauma or illness requiring urgent short-term attention. Today physicians apply specific prescribed treatment of surgery or drugs, aimed to treating the immediate problem. The aim is to keep us alive in the short term at any cost. And, put like that, who’s going to argue? The concern, however, goes a bit further than that. We’ve known for many years this interventionist approach just doesn’t work. We pay an increasingly unacceptable cost for being patched up like this, our health continues compromised and no cure is effected.

Instead, what we get is “managed chronic disease”, skilled physicians and technicians, along with our hospitals supported every step off the way by the drug majors and medical insurers, presiding over chronic decline, not cure.

It is a sad state of affairs that an acute-care approach lacking the means and the knowledge for the treatment and prevention of complex chronic disease prevails to the extent that it does. An approach that ignores the genetic makeup of the patient as well as the environmental and lifestyle factors involved. Too few physicians are adequately trained to assess and diagnose the metabolic causes of chronic illness. It does not reflect well on the medical profession as a whole that both the problem and the solution have long been known and yet the refusal to accept the obvious and to treat the sick both more preventatively and more successfully continues so as to protect, or so it seems, a business model that has been found wanting and is increasingly seen as unsustainable. All the more regrettable is an unconscionable 50-year time lag between established and emerging research in basic sciences such as clinical nutrition and the way doctors practice in their treatment of chronic disease.

It’s taken about forty years, but the tipping point may soon be upon us, as more and more doctors and hospitals start to practice integrative health care. The reasons for this long overdue shift can be put down to the generational rise of younger doctors entering the profession and resonating with the dissatisfaction of increasingly informed patients, no longer prepared to accept the sub-optimal health results delivered by the traditional medical model that will not or cannot meet their needs.

Do not, however, expect the old order to go quietly. They can and do fight tooth and nail to protect the status quo and their prerogatives. Doctors and scientists who cross the line can expect to be ignored, mocked, legally sanctioned and even denied the right to practice.

Functional + Big Med

Doctors specializing in integrative medicine are fully qualified in conventional medicine and recognize its benefits. However they do go on to study and employ other long ignored science-based therapies, the heart of which is the metabolic approach to medicine known as functional medicine coupled with what’s termed orthomolecular medicine (the science of food-based nutritional supplementation), along with a broad range of other complementary or adjunctive natural therapies, which can include detoxification, acupuncture, meditation, therapeutic body work, de-stress, diet modification, physiotherapy and exercise, and even homeopathy.

The essential aspect of this is the shift from the disease-centered focus of medical practice to a much more patient-oriented approach; functional medicine addresses the whole person, not just an isolated set of symptoms. Functional medicine is, above all preventative, operating at the molecular level. Through a variety of sophisticated diagnostic tests, mostly ignored and seldom employed by conventional medicine, practitioners go much further to assess and treat the patient’s fundamental clinical imbalances and underlying triggers of dysfunction at cellular and hormonal level, plus the environmental and lifestyle factors that affect genetic makeup, before they become serious of life-threatening chronic conditions.

What functional medicine does is to address the most common symptoms of chronic health problems usually experienced as pain, inflammation and fatigue. The medical problems associated with these symptoms are:

• Chronic fatigue

• Muscle pain

• Arthritic pain

• Allergies

• Metabolic problems (pre-diabetes)

• Hypertension

• Dyslipidemia (high cholesterol)

• Prostate problems

• Cognitive impairment

• Eczema & psoriasis

• Fibrocystic breast disease

• Gastrointestinal & digestive problems

• Depressed immune system

• Hormonal & auto-immune dysfunctions.

Although none of these problems are immediately life-threatening they are chronic problems that can, if not corrected in time, develop into much more serious conditions, most notably the cancers, diabetes and heart disease that so often kill or disable us.

Happily most imbalances in functionality can be addressed. Either completely restored to optimum levels or at least substantially improved. Prevention as ever is the key. Almost every complex, chronic disease is preceded by long-term disturbances in functionality. Functional medicine greatly extends the physician’s armory. Treatments may include combinations of drugs, botanical medicines, nutritional supplements, therapeutic diets and bodywork along with de-tox programs or the referral to specialists as required.

From the nature of the above it should be very apparent why the oversight of a fully qualified medical doctor is absolutely necessary when opting for the functional medicine approach. The other adjunctive or complementary therapies involved in the integrative approach are usually available through on-staff practitioners or by referral to approved outside therapists.

So where can you find a doctor practicing integrative of functional medicine and how would you know one when you found one?

An integrative clinic as I define it here, should fulfill the function of General Practitioner (GP), providing a range of treatments and advanced diagnostics of a functional medical nature with on-staff MDs, clinical nutritionists and other skilled practitioners to provide the necessary preventative and interventional treatments necessary for the wellbeing of their patients.

Some such clinics combine or even make most of their income from cosmetic treatments rather than the provision of a dedicated general practitioner service.

There is no intrinsic reason why the two cannot be combined but my observation is that the GP function inevitably suffers when the main business of a clinic is aesthetic. A quick look around the waiting room can quickly inform you as to this.

The Naming of Names

A word on nomenclature. The field of alternative or complementary health abounds with practitioners of one discipline or other. Some of these are excellent in their special fields, some less so. However talented in their own area they are not medical doctors (MD) or physicians in the accepted sense. Thus doctors of naturopathy, homeopathy, chiropractic, etc., however excellent and knowledgeable generally are often qualified and restricted to their own area of expertise. The term ‘clinic’ most usually applies to a private or specialized hospital with at least one full time doctor of medicine (MD) in full time attendance.

Properly applied the terms Functional and Integrative Medicine should always be provided under the direction of an MD. Other less specific but descriptive terms in the sector include, anti-aging, wellness, holistic, alternative, complementary, optimum health, vital life and so on. Establishments employing these words or phrases may or may not involve the services of an MD but usually offer a number of complementary or alternative services from a variety of health care practitioners. Standards vary depending on the talents of individual practitioners and on the level of management, so it’s up to you to exercise due diligence.

Lastly, none of the above should be taken to detract in any way from the historic and ongoing contribution made by conventional medicine and its physicians and scientists. As one of the most talented integrative MD’s I know observed to me a while back:

“When you got a Big Problem, you need Big Medicine.”

True….. but it’s just that big guys have run away with the ball game… and the rulebook.

That’s why modern medicine as practiced today is unsustainable. We need a revised model and we’re only going to get that if we insist on it.