So I went to see a doctor
As of this writing, I have recently reached the ripe age of 32. I don't remember the last time I saw a doctor for a routine check-up and my most recent bloodwork was to attain that wonderful adult dream asset, life insurance. Outside of that, I have fortunately not had to step foot inside a doctor's office. However, given this new age milestone and a nagging mother, I was actually interested and willing to go see someone to do some bloodwork and find out if my diet and lifestyle was supportive of everything working on the inside. The problem is apparently in today's society you need a primary care physician or at least a relationship with one to go see them. Further, even if you had a relationship with a doctor, you are only supposed to see them when you're sick. I struggled with this concept as I didn't want to just go to any physician nor was I sick.
I was accustomed to the way the general healthcare system works where you ring the bell, the fogged glass slides open, you sign in, you sit in a waiting room, 40 minutes later you are called into door number one, a nurse takes your height, weight, and blood pressure, screens you for any symptoms and the reason for your visit, you're assigned a room, then you're informed that the doctor will be in shortly. After another 45 minutes and after you have read every drug pamphlet, chart of the human body, and played with the cotton balls on the desk, there is a subtle knock on the door and in walks the white coat. He or she takes 2 minutes to look at your chart then asks why you're there if you have no symptoms or illness. God forbid you try and engage in conversation about wanting to check in on your general wellness or order some baseline tests to see where your health is at. Doctors in the system are just not interested. They don't have the time to sit down and learn your history or talk about your lifestyle to get a grip on your situation or why you might be interested in getting some bloodwork. There is not a prescription to be written or symptom to cure. Also, there's no way you're going to get a follow-up visit to go over the results. So where do we turn?
Thank goodness for functional medicine and its practitioners. But, what is functional medicine?
The Functional Medicine approach deals directly with the underlying cause of a health issue and treats each patient as a whole, unique individual. Practitioners work together with health coaches, nutritionists, and other allied health providers to support patients as they make their journey toward wellness. Practitioners take the time to evaluate patients on an individual basis to learn about their past and current lifestyle factors that have a direct impact on their health and wellness. Functional medicine looks to find the root of a problem rather than just treating the symptoms. Practitioners look for lifestyle, diet, or other interventions before thinking about a pill or other clinical solutions. Functional medicine practitioners can serve as a guide towards wellness and are useful individuals to lean on in order to more closely understand how lifestyle factors can play in the health or illness of an individual. They are able to dedicate time and energy to each patient with typical initial consultation times of up to 2 or 3 hours. Documentation is critical and followup visits are scheduled in order to track progress and see how changes actually affected the patient. The crux of functional medicine is its focus on prevention rather than treatment. This is what drew me to seek out a functional medicine practitioner.
More and more, I have come to realize that our individual health is in our own hands. We determine whether we want to rely on conventional methods of treatment or enlighten ourselves with other avenues of information. With something so important as health and wellness and given my goal of longevity, I am innately drawn to seek out such information. However, if you are someone who doesn't have the time or the interest, I highly suggest seeking out a functional medicine practitioner to guide you along as they keep an open mind to new treatment strategies and are open to evolving as new information becomes available. I have found that one severe flaw in our current medical system is the primary and continuing education of our doctors. The curriculum and training courses are largely sponsored by the drug industry which conveniently shuts its eyes or turns its back on any strategies or treatments that may render their drug useless. Further, large research hospitals and universities rely on grants and funds from these same drug companies in order to carry out their clinical studies and ongoing educational programs. Here is a recent article about the role of oxycontin's manufacturers and where they chose to donate their dollars. Due to this flaw, our doctors are bred out of a flawed system and can only practice what they know. It is not a failure of the individual doctors, it is a failure of the system from which they are created. This systemic flaw is what led me to functional medicine.
I wanted a practitioner that was going to learn about my past, ask me questions about my goals, and create a plan to keep me on that path. Further, I wanted an educated resource that I could bounce off ideas for lifestyle interventions that would have an open mind and actual experience in dealing with. Side note, the last doctor I saw in the conventional health system had no idea what a keto diet was and was astounded at my very basic knowledge of metabolic health and fitness. It was disheartening that I was educating the very person I came to see about my issue. Needless to say, I needed to find a functional medicine practitioner willing to take me in.
How do I find a functional medicine practitioner?
Through my research, I have found the Institute of Functional Medicine (IFM) to be the gold standard in educating its practitioners, having a keen eye on the latest studies and information, and having the resources available to support its practitioners and their patients. Therefore, I would highly recommend seeking out a practitioner that has been certified by the IFM. They have a great search tool that allows you to locate a practitioner near you. If there isn't one near you, it isn't the end of the world. There are many individuals that have become enlightened to this treatment methodology and are full of the information needed. Search for holistic medicine specialists, ancestral medicine specialists, or even primal health coaches. All of these individuals have rewound the clock on treatment strategies and have rewired their approach to be one of prevention and root cause analysis rather than prescription treatment and symptom mitigation. Don't be afraid to pick up the phone and call. I must have called 5 practitioners before I landed on my choice. Challenge them with their process, ask them how much time you will have with the practitioner, inquire about their contact availability, and their overall patient management. It is your health, so invest the time into finding someone that is going to give it the same care and attention that you would. Once you make the selection and experience the difference, I guarantee you will not look to the conventional medical system again.
What should you expect?
As stated above, initial consultations are important, if not the most important part of the functional medicine process. Expect the practitioner to schedule you for a 1-3 hour session in which you are expected to share all things that may have impacted your physical and mental health in your life. Key factors such as family medical histories, events of trauma, psychological or physical abuse, relationships with diet or exercise, and even your personal feeling of value and fulfillment in life. All these factors go into painting the picture of the patient and will lend insight to the practitioner in order to find a root cause of an underlying illness or symptom. Remember, these practitioners are trained to evaluate their patients with the understanding that our bodies are not meant to just break down, become inflamed, develop an illness, or show other signs of wear and tear. They understand that these are signals of damage and they want to provide the support to repair the true cause of these items. They work with a network of specialists such as nutritionists, endocrinologists, psychiatrists, and others that they can then refer and collaborate with in order to develop a personalized wellness plan. This initial consultation is just as important for the patient. The doctor will only know as much as the patient is willing to share. Thus, it is integral to be as open and honest as possible. Expect to become emotional, uncover some hidden demons, or interpret some past life occurrences in a new light. This consultation will drive your future path, so it is critical that the information is available to ensure the path is the right one. Of course, along with the consultation, there will be surveys and questions regarding your symptoms or any medical issues bugging you. The best part is that it is okay to just be there to assess your health. For me, as stated above, I wanted to create a resource that I felt comfortable checking in with bi-annually through conversation and the tracking of key metrics. I was seeking a knowledgeable, interested consultant. Of course, every treatment plan will come with a comprehensive blood test in order to provide the practitioner with hard data to interpret how your body is functioning on the inside.
Getting blood drawn can be scary or daunting, but in the end, it is necessary in order to provide some key metrics to evaluate your health. The comprehensive tests will include markers such as cholesterol, hormones, metabolic markers, glucose, insulin, kidney function, thyroid panels, and even others as your practitioner sees fit. The underlying theme is consistent with the practice. The practitioner wants to see the body as a whole, as it is all related. These blood tests will be able to link the soft consultation data such as diet, exercise, and stress levels to the true biomarkers. You will be able to gain insight as to how your daily activities play into the true performance of your body. This approach will help you appreciate the link between our daily choices and how we may come to develop certain illnesses. Once your results are in, it will be time to interpret them.
During your follow-up visit, these biomarkers will be discussed with the practitioner in another hour to two-hour session. The numbers aren't just thrown on a screen and left for you to interpret. The practitioner will help educate you on each, how they interact with other functions of the body, and even link your lifestyle to each. For example, I personally have an underactive thyroid which has probably been caused by a stressful lifestyle. Thus, solutions are more in the form of managing stress and diet intervention in order to support and restore the function of the gland rather than prescribing drugs to mask the symptoms. It is a truly enlightening experience seeing how numbers on a piece of paper that used to just be given with a range in green or red can be related to lifestyle interventions, family history, or other parts of the body. Of course, this session resonated with me the most given my interest in the human body and optimizing it for performance as well as feeding my need for data; but, I know the experience will be beneficial to all that experience it. This session will be key to developing how your relationship with your practitioner will progress. Given the severity of the results, followup visits and interventions may be prescribed for a shorter time frame than an individual that had better results. You may be referred to an area specialist if, for example, an alarming kidney or heart issue was uncovered. However, you can remain assured that this is not the last time you will see the practitioner and be able to reevaluate your results. From this visit, it is up to the patient to implement and invest in the plan that is developed. It may be to lay off the exercise, eat more zinc, sleep more, or change up the daily routine. Either way, the interventions will be one of lifestyle, not a prescription, and should result in deeper and root cause solutions. This type of treatment of course has some flaws.
What is the downside?
The major hurdle to clear within the functional medicine space is the cost. Many visits for wellness are not covered by insurance, and further, some of the tests that may be ordered, if not for a diagnosis or illness mitigation reason, may not be covered by insurance either. It is common for the initial and follow-up visits to cost several hundred dollars and for any uncovered tests to be the same. I can appreciate that this is no small sum, but in the grand scheme of achieving optimal health and living out a long, fulfilling life, one may come to more likely accept these costs. Further, the practitioner's office staff and testing centers are extremely knowledgeable in working with insurance and providing alternative methods.
Another hurdle is that the effort is shifted to the patient. As discussed above, there will not be a pill or injection prescribed to alleviate the symptoms, thus the patient will have to put in the work to implement the prescribed strategies in order to make the change. As an exercise addict myself, it is hard to accept that I may need to dial it back in order to help my body recover; however, if I truly want to optimize my health and performance, I will need to implement the strategy in order to get the desired result. It may be a new diet, new sleep routine, or implementing meditation; either way, it will be on the patient to incorporate it into their lives. A much tougher step than taking a pill or applying a cream two or three times a day.
Lastly, I can see how time and patience may be a factor. It is tough to find a couple of hours during the week to visit a doctor and to take the time off work may seem detrimental. However, I can assure you that the process is worth it. Also, the results will not come quickly. Lifestyle interventions may take weeks and months to reap the benefits from as you are typically battling and unwinding years of doing it differently. Many individuals lose hope or faith in the process. This is where the accessibility and communication with the practitioner are key. Seek out those that have the ability for uncharged, quick check-ins, or those that provide emailing and messaging services. Patience will play a key role in your journey, but having comforting support from your practitioner will make it so much easier.
I am so glad I chose this route and found a practitioner willing to listen to my goals and structure a plan to guide me towards them. This path is not for everyone as many are accustomed to viewing doctors as the end all be all of optimal health; however, I ask many to look at their own doctors and challenge their appearance, knowledge, and lifestyle. Many of our doctors, nurses, and medical professionals have fallen victim themselves to our obesity and chronic disease epidemic (Article) so we should challenge our faith in them. Many functional medicine practitioners have chosen the practice out of the true pursuit of wellness and most likely, personal struggle with an underlying illness or disease that the conventional system was unable to solve. Am I saying we don't need doctors, absolutely not! When you break a bone, require surgery, or experience trauma, no amount of diet or lifestyle intervention will save you. However, if we can shift our focus to prevention and utilize the professionals that focus on this approach, we can change the tides of our population towards a healthier, more productive majority.
Please leave your questions and comments.
As always, thanks for reading.