Functional medicine is a philosophy
Often patients call my office looking for a physician that will treat them like an individual, answer their questions, and honor their wishes. That’s it, nothing too complicated just basically a little respect. I can provide that too all of these patients but sometimes they need more. That may be the need to see a specialist or a necessary prescription for medication. To find like minded individuals I recommend they look for a functional medicine doctor. Functional medicine doctors focus on preventive medicine and try to get to the root cause of a person’s problems. Semantics are a big problem when communicating so by root cause I do not mean the diagnosis. Diabetes, hypertension, or obesity are not root causes. They are down stream effects of imbalances. By root cause I mean why are specific cells in the body functioning abnormally. Only with abnormally functioning cells do you get diagnosable diseases. Functional medicine doctors recognize that there are genetic components to diseases but they more importantly understand that the environment almost always plays a role in the development of disease. In my opinion traditional medical schools focus on diagnosis and treatment. The cause for some things like a viral or bacterial infection are well known and addressed. Meanwhile chronic disease are called idiopathic (unknown source) and all the multiple factors that contribute to them are recognized but not a focus of conventional medicine.
Who becomes a functional medicine doctor?
Functional medicine is important because medical doctors can have the best intentions for their patient but they are not trained to do disease prevention. And more importantly the entire medical system is not designed for preventive/personal care. It is designed for sick-care (disease management). The best picture I’ve seen to demonstrate this is below.
Functional medicine doctors believe in building a fence at the top of a cliff to prevent people from falling. Maybe put up some warning signs or educate people on the dangers of cliffs and how to avoid them. This is all occurs well before a disease so there is no codable diagnosis for insurance reimbursement. This is not for everyone, in general human nature is to respond to problems after they start. But there are people that want guidance before it gets that bad and even once it starts there are people that want to correct what got them there and not just take medications.
If you haven’t noticed functional medicine sounds an awful lot like naturopathic medicine. I personally don’t separate the two very much but there is a difference on how the titles are earned. First any one can say they are a functional medicine practitioner. Likewise, any doctor can say they are a functional medicine doctor. There are no state licenses, no government oversite, no functional medicine medical schools. There are master degrees that focus on nutritional approaches to functional medicine. But basically there is no regulation you can take classes from anyone offering functional medicine certifications or not take any classes at all and declare yourself an export. Usually functional medicine practitioners have worked in the healthcare field, do not like how they are practicing medicine, and functional medicine philosophically aligns with them. How much education they get is up to them.
Functional vs Naturopathic Medicine
In contrast, Naturopathic doctors have completed undergrad and then graduated from a 4-year doctorate level program with a focus on natural medicine. This difference can not be emphasized enough. During anatomy, physiology, biochemistry, pathology, neurology, and etc. The focus was always on what things cause diseases in these areas and how to support these organ systems naturally using exercise, diet, botanical medicine, and etc. After naturopathic doctors complete 4 years of training, we take board examinations to make sure we are knowledgeable. Then we obtain licenses from licensed states and have some level of oversight from our naturopathic medical board. Depending on the state that you’re licensed we then have as many as 50 hours of continuing education hours each year to complete that are focused on natural medicine to make sure we are practicing the newest evidence-based medicine.
So the difference is not so much in the philosophy but in the path. I’m sure functional medicine and naturopathic doctors would argue with that statement but that’s fine 🙂 Naturopathic doctors are trained in modalities like physical medicine and botanical medicine so some have that as a part of their practice. Functional medicine doctors do practice a little differently than naturopathic doctors. Often their office is still set up like a medical doctor’s office with a receptionist and medical assistant and/or nurse. The big difference that a patient would notice is the amount of time spent with them, usually it’s a cash practice, and most important the test. Functional medicine doctors will do test like stool analysis, salivary hormone testing, urine neurotransmitter test, intestinal permeability testing, breath testing, and etc. These tests are often not FDA approved but can give valuable information if investigating the root cause or if you’re trying to learn about the patient’s individual chemistry.