Current State of Affairs
Preventive Medicine. That seems to be a buzzword in the world of 21st century healthcare. Many people have called for a reformation of healthcare, stating that too much emphasis is put on treatment of issues as they come up, instead of preventing the issues from occurring in the first place. The current model, it is safe to say, relies on an issue being present. Someone goes to the doctor when they don’t feel well, the doctor finds the root cause of the problem, then offers solutions, generally in the form of medication. Problem solved. But with the latest generations living longer and the rise of chronic conditions, throwing medication at the problem does not seem to do the trick. So what is the answer?
Out with the Old…
A new movement, yet old theory, in the US has begun to gain ground: Functional Medicine. The phrase is not something of familiarity. It has been used in other phrases, such as function fitness to describe fitness that can be used to achieve overall fitness, instead of strength or conditioning specifically, and targets multiple muscle groups. Within the realm of medicine, Functional Medicine aims to “…[address] the underlying causes of disease, using a systems-oriented approach and engaging both patient and practitioner in a therapeutic partnership.” As interesting as it sounds, the real question becomes, what is this and how is it different from preventive medicine?
What is the New?
Functional Medicine is a proactive approach to treatment by addressing patients’ lifestyle habits and allowing positive changes here affect their illness and issues. So, instead of waiting for the atherosclerotic plaques to line arterial walls, a functional medicine practitioner sits down and discusses diet to at the first consultation, as well as exercise and nutrition. Essentially, they are looking for signs of negative behaviours that may wreak havoc on a patient later in life. Again, this is not a foreign concept. Many people engage with this via nutritionists, dieticians, and personal trainers on a daily basis. But when is the last time you walked into a doctor’s office, said you felt fatigued and were sleeping poorly, and he gave you a prescription for exercise? In this day and age, the patient philosophy of the doctors is one of hand-over-the-pills. But as doctors, is it not your knowledge that trumps patient wishes? Especially if it is in the best interest of the patient? This is where Functional Medicine comes in; the reprogramming of the doctor’s role in healthcare from the guardian of drugs to a knowledgeable professional that aims to increase overall health, instead of a curing a single problem.
Compare and Contrast Preventive and Functional Medicine
The objectives are the same for these philosophies: stop the illness before it progresses to the stage of treatment. Preventive medicine still relies solely on evidenced-based medicine; however, doing prophylactic treatment or early testing to watch out for signs of future illness. Functional Medicine looks beyond the specifics and targets overall health to lead to improved outcomes for future illness and reduce their likelihood of occurring.
Don’t take the above the wrong way. Functional Medicine is rooted in evidence as well, but overall health evidence instead of specific diseases.
… health seems to be the way to go. It not only addresses poor lifestyle habits to decrease likelihood of disease, but it engages the patient in a way that they can understand. Have you ever tried to describe cholesterol build up and how it blocks the arteries over time to someone, let alone say the world artherosclerotic to someone? How about telling someone they have hypothyroidism and they need iodine supplements to treat this? It is hard enough to grasp after 5 years of medical education, and we expect a 10 minute consultation to be enough for the patient to fully understand the illness? Taking the above example and applying Functional Medicine, addressing a patient’s nutrition in both cases can lead to a better and more well-rounded understanding of possible disease and give prevention from the disease occurring. That sounds like a win-win to me. For more information, please refer to the Institute for Functional Medicine link below.
I think that the true test will come in denying patients medication. People get grumpy without those pills they need. Time for placebos… and to move this topic to the ethics section.