What is Integrative and Functional Medicine?

What do these terms mean and why is there new public interest in a parallel health philosophy?  How can we better address disease and guide our patients towards optimal health?

The fact that no one can deny is that our healthcare system is deathly ill.  It's on it's last leg, financially bled dry, doctors are on strike and patients feel like cattle, wearing their insurance codes like ear tags as they are shuttled through generic processing plant hospitals.

Time is money in medicine, personal touches and attention to empathy, last on the list.

Doctors who entered the field because of a deep desire to ease the suffering of fellow human beings become robots entering data behind a computer screen.  We agonize about where to put the details of our patient conversations in the EMR (electronic medical record) rather than actually hearing the pain they are trying to express to us.  We struggle with insurance forms while in the moment forgetting that often our patients need a kind word or a  hug so much more than they require reimbursement.  We are allowed 12 minute visits and brainwashed to believe they should all end with a little white piece of paper granting access to scheduled substances.  This is not medicine. This is absolutely not healing. This is business as usual, and if it is not disrupted quickly, federal spending on preventable chronic diseases will mean a completely broken system.

In the conventional medicine system the aim in not to get people better.  The goal is often maintaining patient numbers, creating a standardized protocol and becoming more efficient at moving people through the system.  

Patients are distrustful and doctors are disillusioned. There must be a better way.

Enter Integrative Medicine

Integrative medicine was born from the naturopathic principles of seeing clients as more than just a medical diagnosis and creating individualized treatment plans to address underlying causes of dysfunction.  Integrative medicine is a patient centred approach that considers factors such as toxic exposures, lifestyle, diet and nutritional status, emotional well being and much more when asking the question as to why someone is sick.  Unlike the conventional model, it does not simply assume genetics and bad luck as causes of disease.  In terms of therapies integrative medicine is open to employing more than just drugs and surgery.  Integrative medical doctors (or licensed Naturopathic Physicians) will use modalities including, acupuncture and TCM, nutrition and lifestyle interventions, dietary supplements and herbal therapies, mind body techniques, exercise prescriptions, bioidentical hormones, injectable therapies as well as conventional treatments. 

Essentially integrative medicine is more concerned with addressing underlying pathology rather than providing quick fix solutions.  If you imagine a warning light on your car’s dashboard; the conventional approach would be akin to taping over the light with black tape so it doesn't bother you anymore.  The integrative medicine approach would be to notice the light,  go to the mechanic for a proper workup, then making the necessiry repairs.

Functional medicine then, is a way of organizing the thinking around an integrative medicine case.  It provides the practitioner with a structural framework to apply their knowledge in a systematic fashion while examining determinants of health or causes of disease.

The functional medicine model uses an elegant matrix design which allows practitioners to input triggers, antecedents, underlying symptoms and lab test results into a one page format which facilitates pattern recognition and more creative visualization and problem, solving (see photo above).

The primary question an integrative or functional medicine practitioner is always asking themselves is WHY? WHY did this patient get sick, WHY did they get sick NOW, WHY did they responded to therapy or not.  Contrast this to the conventional system, which primarily is interested in WHAT.   WHAT is the diagnosis, and WHAT is the treatment. End of story.  While both are completely valid, WHY questions allow a deeper understanding into a case.  

Integrative medicine is the model and functional medicine (and its associated matrix) is the tool.