Functional vs Preventive Medicine

Preventive medicine. It seems to be a buzzword in the 21st century healthcare world. But do we really know what we are talking about?
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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 the treatment of issues as they come up, instead of preventing the issues from occurring in the first place.

What is Functional Medicine?

The Institute for Functional Medicine defines functional medicine as a systems biology-based approach that focuses on identifying and addressing the root cause of disease. Each symptom or differential diagnosis may be one of many contributing to an individual’s illness.

What is Preventive Medicine?

The American College of Preventive Medicine defines preventive medicine as the practice of promoting preventive health care to improve patient well-being. The goal is to ultimately prevent disease, disability, and death. It takes into account factors that influence health such as environmental factors, lifestyle choices and genetic predispositions.

Current State of Affairs

The current healthcare 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 and 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?

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Functional Medicine Background

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 functional 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?

How is functional medicine used?

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 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 the 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 curing a single problem.

Functional Medicine vs Preventive 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 evidence-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 illnesses 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.

Conclusion

Functional Medicine seems to be the way to go. It not only addresses poor lifestyle habits to decrease the 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 diseases and give prevention from the disease occurring. That sounds like a win-win to me. 

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.

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