Functional Medicine Pros and Cons
So I love Jimmy Fallon’s show. I love New York City in general. My grandfather, Max Kalish, was a well known socialist/realist artist and he made New York his home in the early 1900’s and my father, Richard Kalish, grew up on the Upper West Side. Somehow I ended up in California but one of these years I plan on making my way back east. One of my aspirational life goals is to be in the live audience of the Tonight Show and I frequently go to New York but it’s not easy to get tickets. Anyhow, point is one of the segments Fallon does each week is “Pro’s and Con’s” and if you’re a follower of the show you’ll know exactly what I’m referring to. So, having a functional medicine doctor write a pro/con list up, when it’s the subject I’ve devoted my life to and believe in so strongly, is clearly going to result in a heavily biased piece. I am going to, as best I can start with the downsides to functional medicine in jest and let’s see where we end up with all this.
First the Jimmy Fallon version:
- Functional Medicine has the word “Fun” in it, so can’t be all bad.
- Functional Medicine is way better than Dysfunctional Medicine however you slice it.
- Functional Medicine doctors believe you can eat a lot of fatty foods and these doctors think butter is better for you than margarine, a rib eye steak is absolutely fine and sour cream is healthy as long as it’s from grass fed cows that have had deep tissue massages while living in Marin County within sight of the Pacific Ocean.
- Functional Medicine means you have to stop all alcohol, coffee and energy drinks and the most you can do for stimulation is a cup of green tea chock full of antioxidants.
- You have to eat your vegetables.
- You’re going to have conversation after conversation with waiters about what on the menu is gluten free.
Ok, moving on to the serious side of this, let’s figure out what really makes functional medicine tick. What makes it special, how does it work and why would you want to find a functional medicine doctor. Let’s contrast that with the pro’s of conventional medicine, what it’s best at and in what circumstances one should rely on conventional treatments.
Pro’s of Functional Medicine
Functional medicine gets to the root cause of health problems and results in long term solutions that help patients avoid exposure to potentially harmful treatments. Functional medicine treatments tend to have very few side effects, if any, making them less risky than drugs or surgery. Avoiding medications unless absolutely necessary prevents exposure to many dangerous side effects. Surgery also can generate many complications in the recovery process such as infections and the dangers of using antibiotics in how they impact the GI tract microbiome.
Functional medicine empowers patients to act to help themselves. Reality is most of the reasons we are all sick, tired, overweight and stressed are self-generated and now amount of medications is going to resolve the underlying problems. By becoming part of the solution and modifying behaviors such as food choices, exercise time and sleep habits people learn how to take care of themselves. In the long run this creates a multi-layered level of benefits that can last a lifetime.
Functional medicine in my experience costs a fraction of the amount of money as conventional procedures, saving us all in the long run from the downward spiral of economic ruin our country is looking at as health care costs escalate year after year.
Con’s of Functional Medicine
The main problem is people don’t like to change. Honestly, if it’s a choice between eating broccoli, cabbage and swiss chard every day to lower your cholesterol and you could drop it faster with a one pill a day statin approach, and still eat all the cheese, fried foods and sodas you want, why not go for the pill? It’s an easy out and is appealing to our sense of indulgence whereas the asceticism involved in eating vegetables with every meal and reducing fried foods and junk food is hard to swallow for a lot of people.
There’s the whole lazy factor. Would you rather relax and watch TV or go on a vigorous bike ride? Would you rather stay up late and watch a movie or go to bed at 10pm? We all want everything we can get. The ice cream, the late movies, the sitting around stuff of life. Hard exercise, early to bed, meditating and eating super healthy food just seem like unpleasant options to a lot of people, taking the fun out of life.
Another huge Con of functional medicine is that it’s complicated. Taking an antidepressant pill once a day is pretty simple. Taking supplements, initiating diet changes and the complexity of many functional medicine treatments turn people off.
One area that conventional medicine is always ahead on is emergency medicine. Broken bones, trauma from a car accident, a sudden heart attack or stroke, all of these require immediate conventional care and functional medicine doesn’t even attempt to address emergency conditions. So a world without conventional medicine would be a world without much needed medical care. Urgent surgeries such as a ruptured appendix and so on.
Problems Facing Functional Medicine
I think the biggest problems facing functional medicine relate to education. We simply don’t have thorough, well thought out functional medicine curriculums that take doctors from the intellectual underpinnings of the theories of functional medicine, through the science, the research and then ultimately the clinical applications the field demands of us. There are fine institutions such as the Institute of Functional Medicine that educate doctors but they are no integrated into our medical schools, hospitals or the sprawling medical delivery systems we have developed.
Therefore we have a problem in delivering the volume of care needed. I hope through the Kalish Institute and our training programs to make a small dent in this problem and feel like our courses are one component of an as yet to be created more comprehensive system of education for physicians.
The other problem facing functional medicine that will likely slow it’s growth more than anything is the fact that it’s so cheap to fix problems using functional medicine it works against the traditional health care profit centers of pharmaceutic sales and conducting expensive medical procedures such as surgeries. It’s challenging for an upstart, unregulated and unknown field like functional medicine to carve dollars away from the well-entrenched medical/financial conglomerates we’ve created since the late 1940’s.
I have a very positive attitude toward all this counting on us humans figuring this all out sooner or later. And in my practice and in my teaching programs I see progress and results that encourage me to stay in the “Pro Functional Medicine” camp.