In today’s medical system, often-overbooked doctors, nurses, and other professionals are trained to identify an illness or injury and treat it accordingly. You come in with a broken ankle or pneumonia, you get booked for surgery or handed an Rx.
“That’s what our healthcare system is designed to do: take care of sick and injured people,” explains Sujit Sharma, M.D, a pediatric physician at Children's Healthcare of Atlanta. “And it does a really good job of that." The problem is that we don’t really prioritize disease prevention, Sharma says. Plus, he adds, "doctors aren’t trained about the importance of nutrition, which is a major missing piece of the puzzle."
The Functional Approach
If conventional medicine seeks to answer what is wrong with your body, functional medicine doctors ask how and why issues occur and seek to restore health by addressing the root causes. It’s only been around since 1991, when Equinox Healthy Advisory Board member Jeffrey Bland, Ph.D., a biochemist and nutritional researcher, founded the Institute of Functional Medicine (IFM). But interest is certainly growing: Their referral network now receives more than one million annual searches, compared to just 50,000 two years ago, according to the IFM.
As Lynn Flowers, M.D., a functional medicine doctor in Atlanta, puts it, “We’re looking for processes in the body that may be causing a certain set of symptoms, rather than diving straight into a diagnosis." For example, say you’re having joint pain. “What’s really driving that inflammation? Do you have an inflamed gut? Do you have an autoimmune disease? Nutritional deficiencies?” Those are the questions functional medicine practitioners want to answer, Flowers says. Consider it a more personalized approach to medicine.
And no, this isn’t pseudoscience or quackery, as some detractors have called it. Rather, these are real healthcare professionals using real science and real medicine. Like Flowers, functional medicine practitioners must have an accredited healthcare degree (such as medical doctors, registered nurses, registered dietitians, or others). Then, they must go through the IFM’s certification program, which consists of seven courses, a case study, and a written exam. It can be completed in as few as one and a half years and up to seven. (Clinicians can still only apply their functional medication certification within the scope of their practice.)
The Target Patient
The functional medicine approach can be especially helpful for people who have perplexing and long-lasting health conditions, such as joint pain or digestive issues, according to the IFM. But really, it can benefit anyone looking to optimize their health.
For athletes in particular, it can complement your training, helping to improve both your performance and recovery. “The functional medicine specialists leading the field use some well-validated lab tests to better understand an individual’s internal physiology,” explains Sharma. “For instance, how well does a person convert calories into energy; or could suboptimal vitamin D levels be contributing to their ability to recover better from exertion?”
To prepare for an initial visit, you’ll have extensive bloodwork and you might have specialized labs like a saliva test to check hormone levels or a diagnostic stool analysis to assess your microbiome health. You’ll also fill out lengthy questionnaires delving into your healthy history, current lifestyle, and what kind of symptoms you’re experiencing.
Many functional M.D.s will sit down with you for at least one hour (usually longer) to go over your blood test results in detail, reviewing your metabolism, nutrient deficiencies, any abnormal hormone levels, cell health, and other health markers. “From the outset, we’re planning to have an unhurried visit to hear a patient’s full story,” Flowers says. At the end, you may leave with a prescription, if you have low thyroid hormone levels or high blood pressure, for example. But you’ll also receive doctor-directed lifestyle changes to make (meditation, yoga, or other ways to reduce stress), supplements to take, and certain foods to avoid or introduce in your daily diet.
Perhaps most importantly, for functional medicine to be successful it requires a collaborative patient-doctor relationship which includes check-ins and follow-up visits, changing your treatment plan as needed, and re-testing to make sure your markers are improving. “We ask people to be participants in their health," Flowers says.
The Fine Print
One downside: Most functional medicine visits aren’t covered by insurance. “We fee by time and not by diagnosis,” Flowers explains, while insurance typically covers a diagnosis, drug, and treatment. This means that out-of-pocket costs can be high (expect to pay at least $400 for an initial consultation, not including labs, which may or may not be covered by insurance).
If you want to try it, start your search with the IFM’s directory, where clinicians are listed by specialty, location, and accepted payment methods. Rest assured that all IFM Certified Practitioners hold a healthcare degree from an accredited program as well as a current healthcare license in their area of practice. However, it’s still the patient’s responsibility to investigate the clinician’s experience and qualifications, and determine whether it’s a good fit on both sides. (Here’s a list of suggested questions that you can ask a potential functional medicine healthcare provider.)