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Functional Medicine – What is it?
After extensive searching and examination, my answer is still – only the originators of “FM” know. Or, at least one must assume they know, because so far as I can see, I certainly see nothing that distinguishes “FM” from other descriptions of sectarian and “complementary/Alternative Medicine/” practices. A difference may lie in the advocates’ assumptions to have found some “imbalance” of body chemistry or physiology before applying one or more unproved methods or substances. From what I could determine, the “imbalance” or dysfunction is usually either imaginary or at least presumptive. And the general principles are so poorly defined as to allow practioners vast leeway to apply a host of unproven methods.
I figured there would be several ways to find out. One would be to read FM’s material – mainly what “they” placed on the Internet. Another would be to enter the system and find out as a patient or as a prospective practitioner what it is that “FM” claims to be. The third would be to listen to a practitioner or advocate on tape, disk, radio, etc.
I certainly cannot or will not enter as a physician, being retired and a poor spy. So the Net and a local radio talk show host have to suffice. I will take on several of their documents on the Net which one can read oneself, and that I will handle in two truncated reports, and the “FM” practice in a third.
On the Web page (Institute for Functional Medicine), http://www.functionalmedicine.org/index.asp) one finds the following:
Functional medicine is personalized medicine that deals with primary prevention and underlying causes instead of symptoms for serious chronic disease. It is a science-based field of health care.
Stop here. “Personalized medicine”: This is an implied straw man argument, implying that medicine is not personalized. Yet in standard medicine, every person’s case is dealt with as “personalized” by physicians.”
Primary prevention“: This is a valid term originally applied to prevention of disease by modifying the risk factors that contribute to development of disease. There is nothing unique here.
“Underlying causes instead of symptoms”: Another straw man implying that medicine treats only symptoms, not causes – straw man and false.
According to the site, Functional Medicine “… is grounded in the following principles”:
Biochemical individuality describes the importance of individual variations in metabolic function that derive from genetic and environmental differences among individuals.
“Biochemical individuality” is a trick expression here. It was invented by Dr. Roger Williams of U. Texas 50 years ago to justify administering massive doses of vitamins and other supplements for “optimum health.” Linus Pauling adapted the concept, along with Soffer and Osmond’s massive vitamin concepts of “Orthomolecular Medicine.” In response to the “orthomolecular” movement, Victor Herbert MD responded that “Orthomolecular Medicine” meant what Humpty Dumpty said about words in Through the Looking Glass: “… it means exactly what I choose it to mean – neither more, nor less. “ No such need for supplements has been discovered.
Patient-centered medicine emphasizes “patient care” rather than “disease care,” following Sir William Osler’s admonition that “It is more important to know what patient has the disease than to know what disease the patient has.”
Another straw man phrasing designed to separate medicine from one of its great teachers, and then to usurp his teaching and turn it into a form he would have rejected. I have never seen a medical text advising “disease care.” Diseases are defined and dealt with as entities in order to classify them, analyze them, and to discover treatments for them. This method is called “scientific method.” It is always a patient who is treated, with treatments proved through scientific method.
Dynamic balance of internal and external factors.
This verbiage is too vague and general to allow analysis. It could mean just about anything. To analyze each word combination would not add to understanding. The authors might know what they meant but a reader would not.
Web-like interconnections of physiological factors – an abundance of research now supports the view that the human body functions as an orchestrated network of interconnected systems, rather than individual systems functioning autonomously and without effect on each other. For example, we now know that immunological dysfunctions can promote cardiovascular disease, that dietary imbalances can cause hormonal disturbances, and that environmental exposures can precipitate neurologic syndromes such as Parkinson’s disease.
Here the advocates expose their naivete and lack of comprehension of physiology and patho-physiology. At the same time they draw conclusions from incomplete and inadequate information (immunologic dysfunction and cardiovascular disease.) A “network of interconnected systems” says nothing other than the body and its organs and tissues are connected and each affects one or more other organs. Is this new? Only if one misperceives the entire history of science and medicine and the information developed over the past 400 years, then substitutes for that history an entirely fictitious one in which organs are individual organisms that function independently of the others – i.e. the ears are not connected to the brain, which is not connected to the muscles … etc. This false argument is invented in order to present an appearance of special distinction; its purpose being to enable a random, disordered treatment approach of “special,” false distinction.
Health as a positive vitality – not merely the absence of disease.
This definition of “health” as something more than “absence of disease” has been trumpeted for forty or more years and has yet to have developed any meaning, although many people nod their heads in affirmation at its utterance. These are “Animal Farm” moments, yet a gold mine of them is here in this description.
Promotion of organ reserve as the means to enhance health span.
“Organ reserve?” There is such a thing as “reserve”, but so far as I know there is no “reserve” of an organ that can be built up or augmented by an intentional treatment, diet, life-style change, or supplement. Reserve stores of iron and other metabolic materials and vitamins can be augmented, but reserves of an organ?
The description continues. Read this section through without interruption if you can. Then read it through again, identifying what is meant by each statement, phrase, and clause. Reader may see why I will stop the analysis at this point and let the advocate/writer’s words speak. I figured someone must be disguising a leg-pulling exercise here. Or, could it be that someone has misunderstanding of such a degree that would result in such language misuse?
In the next installment I will identify some of the originators and players and try to use examples of how one or more practitioners use “FM”. Now, try your hand at the following:
Functional medicine is anchored by an examination of the core clinical imbalances that underlie various disease conditions. Those imbalances arise as environmental inputs such as diet, nutrients (including air and water), exercise, and trauma are processed by one’s body, mind, and spirit through a unique set of genetic predispositions, attitudes, and beliefs. The fundamental physiological processes include communication, both outside and inside the cell; bioenergetics, or the transformation of food into energy; replication, repair, and maintenance of structural integrity, from the cellular to the whole body level; elimination of waste; protection and defense; and transport and circulation. The core clinical imbalances that arise from malfunctions within this complex system include:
Hormonal and neurotransmitter imbalances
Oxidation-reduction imbalances and mitochondropathy
Detoxification and biotransformational imbalances
Immune imbalances
Inflammatory imbalances
Digestive, absorptive, and microbiological imbalances
Structural imbalances from cellular membrane function to the musculoskeletal system
Imbalances such as these are the precursors to the signs and symptoms by which we detect and label (diagnose) organ system disease. Improving balance – in the patient’s environmental inputs and in the body’s fundamental physiological processes – is the precursor to restoring health and it involves much more than treating the symptoms. Functional medicine is dedicated to improving the management of complex, chronic disease by intervening at multiple levels to address these core clinical imbalances and to restore each patient’s functionality and health. Functional medicine is not a unique and separate body of knowledge. It is grounded in scientific principles and information widely available in medicine today, combining research from various disciplines into highly detailed yet clinically relevant models of disease pathogenesis and effective clinical management.Functional medicine emphasizes a definable and teachable process of integrating multiple knowledge bases within a pragmatic intellectual matrix that focuses on functionality at many levels, rather than a single treatment for a single diagnosis. Functional medicine uses the patient’s story as a key tool for integrating diagnosis, signs and symptoms, and evidence of clinical imbalances into a comprehensive approach to improve both the patient’s environmental inputs and his or her physiological function. It is a clinician’s discipline, and it directly addresses the need to transform the practice of primary care.
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