Keeping Up with the Kalish's- Treating Chronic Illness Exclusively

My main functional medicine teacher Dr. Timmins died ten years ago this week and it’s been a time of reflection for me about the past and the history of our field of functional medicine as well as about what I see in the future for our community. All the early pioneers in our field worked diligently to help those suffering from chronic illnesses such as Lyme, chronic fatigue, heavy metal poisoning, autoimmune disease, cancer and the list goes on. The best of the best amongst the doctors that trained me had the most difficult patient cases, focusing almost exclusively the most complex and often times intractable illnesses. I woke up one day after about four or five years in practice with my own version of a chronic illness case load. Everyone I was seeing was more complex than the previous patient and if I helped one person with chronic fatigue five more even worse cases of fatigue would show up within weeks, word spreads fast in the tightknit communities of patients struggling with these types of conditions. Functional medicine was picking up the slack created by the conventional medical system. Environmental sensitivities, extreme food allergies, highly advanced cases of autoimmune illness or hard to understand failures of immune function and detox systems become routine patients in the best functional medicine clinics. These were patients who had little to no recourse in the conventional medicine system. It made sense in those days, we called it “alternative medicine” because it was an “alternative” to conventional medicine especially focused on those patients that were completely failed by the medical system. In general I found that if conventional medicine had a solution to offer, those patients wouldn’t come in droves to our clinics. So high cholesterol, diabetes and many other common conditions with clear conventional medical options tended to stay away from most functional medicine clinics. Six years into practice when my son was born, 18 years ago, I wanted to free myself from the constant work required to run my chronic illness practice so I dropped back to part time patient care, working 3 full days a week, and spent every Friday, Sat, Sun and Monday from sunrise to bedtime with my little guy. Kid parks, jogging strollers, I spent 4 full days a week being a dad. No regrets on the choice to focus on parenting. It did require me to reimagine my practice and create a more sustainable business model. I needed to work with patients who would not take up as much outside of clinic hours time, I needed to generate more income since I was working fewer hours and my expenses had increased (mortgage, etc.) and I need to get over the burn out I’d self generated working obsessively for ten or more years between school and starting the practice. Now almost twenty years into this investigation into the types of practices we can create I see a very clear need out there in the general public and a gap in terms of functional medicine providers. Whereas most high level functional medicine clinics still focus on the extraordinary and complex chronic illness cases most of the U.S. population is suffering from quite ordinary diseases, including cardiovascular disease, diabetes and cancer. I’d like to see functional medicine’s future go to where the majority of human suffering is. Obviously not to ignore our roots as the best treatment option for complex chronically ill patients but rather to extend out our reach to address common problems that are preventable if tackled early enough.