It feels practical, patient-centered, and the approach to healthcare that we all deserve. But is functional medicine the all-encompassing solution it promises to be? Following is an overview of functional medicine along with the pros and cons of buying into it.
Functional medicine has become more and more popular over the past decade. This is partially due to advocates and celebrity doctors like Mark Hyman, MD (author of 10-Day Detox Diet and podcast The Dr. Hyman Show), and also because it’s on trend with the ever-growing fascination with health and wellness.
Functional medicine is an approach that aims to identify the root cause of chronic illness, a nuanced difference from a more allopathic or conventional system, which focuses on the treatment of disease (aka how most of us think of traditional health care).
It’s characterized as holistic and individualized and takes into consideration a broad range of factors that can impact health. This includes things thought to be overlooked in traditional medicine, such as extensive lab work, genetics, environment, and mental health. Because of this, functional medicine practitioners may partner with a wide variety of supportive services as part of the treatment plan, such as chiropractors, massage, nutritionists, health coaching, and acupuncture to name a few.
But how do we know if functional medicine is just a trend or if it has merit as the future of medicine?
A quick (but important to know) history:
Jeffrey Bland, PhD and Susan Bland developed the concept in 1990, which was followed by the first formal center, The Institute for Functional Medicine (IFM). The IFM has been accredited by ACCME, an organization that offers continuing medical education credits to physicians. (Dr. Hyman, noted above, is a board member of the organization.) Since then, independent business providing functional medicine have popped up all over the country.
A quick distinction: Functional Medicine differs from integrative medicine, which incorporates supportive practices such as acupuncture, yoga, and music therapy to name a few, as well as Complementary Alternative Medicine (CAM), which includes mind-body therapy and nutrition.
Why is functional medicine gaining traction?
The concept feels practical, supportive, and hopeful, with the promise of uncovering the roots of our illnesses past, present, and future. Ideally, once identified, a tailor-made plan is developed involving a broad range of team members and services to address the root problem.
This can be managed at an in-person facility, or fully virtually, which is an attractive option to some. Dr. Hyman even offers a yearly membership through FunctionHealth for $499 a year which gets you 100+ labs followed by explanations of those results and action plans (AI input included). This does not appear to include personalized Telehealth visits though.
Who is qualified to provide functional medicine?
There are 13 listed degrees/licensures for those eligible for the Functional Medicine Certified Professional (FMCP) certification, in addition to a baseline bachelor’s degree. I won’t list all of them, but to show how much variety there is, the list includes acupuncturist, social worker, dentist, and “nutrition professional.” Additionally, applicants must fulfill 100 hours of accredited functional medicine education sessions offered with a la cart pricing on the IFM website.
Starting in 2026, there will be an exam that applicants will also need to pass with a score of at least 80%.
This is important to know because it frames functional medicine as more of a concept that is incorporated into a professional’s existing practice or expertise. For example, I could be a registered dietitian with an FMCP and practice functional medicine; however, despite the word “medicine” in my title, I would be practicing under a dietitian’s scope. I would not be a doctor.
Where can I get functional medicine care?
It depends. Some areas may have multiple brick and mortar practices to choose among (the Lancaster area has a few), while others may not have any. But many will offer Telehealth appointments. Some practices offer both primary care and functional medicine in one bundle. Others do not.
What do physicians in our area think?
I reached out to Dr. Kaci Christian, MD, a board-certified gastroenterologist who specializes in the treatment of inflammatory bowel disease in Lancaster, Pennsylvania to ask her thoughts on functional medicine.
She replied, “I practice evidence-based medicine which also seeks to understand the root cause of diseases to accurately identify and fix them. This doesn’t mean that a pill is always the answer, and in some cases, a referral to a nutritionist or a “prescription” for exercise may be the better course of action. I fully support my patients involving a functional medicine provider in their care. Patients do not need to choose between functional medicine and traditional medicine — you can use both!”
I had a conversation recently with another local physician, who said, “As an allopathic physician, I practice evidence-based medicine. However, I am also a proponent of a holistic approach to medicine. I strive to recognize the complex needs of each patient. Medications play a role in managing both chronic and acute conditions, but lifestyle modifications (diet, exercise, stress reduction, sleep, etc.) also have tremendous value.”
So why wouldn’t functional medicine be for everyone?
- Functional medicine doesn’t participate with insurance. It’s all out of pocket. The exception is some FSA or HAS will cover some of the costs. This is because insurance companies do not recognize the functional medicine model of care.
- Do I need 100+ lab tests? While it sounds better than only getting five or 20 labs, let’s ask, what do these results tell us? Is there any scientific evidence to support that the additional labs indicate something specific even if the number is technically out of the “normal” range? And how do we, as a consumer, or a patient, know there is legitimacy behind these labs? Or that someone who claims they know how to “fix” it actually can? And once the labs get back into normal range, does that mean the potential problem has been fixed?
This is a point of contention in the medical world. Some say casting a wide net can provide us with so much helpful information, while others may say the results of many labs aren’t evidenced based and don’t give us much information. That, in fact, they are simply numbers that lead us down a rabbit hole towards an unclear end game.
Local psychiatrist, JP Shand, MD (CMO and Medical Director of PerformCare) says, “Those searching for help can be vulnerable to unconventional and non-evidenced based explanations and treatments. But we must be diligent not to abandon evidenced-based treatments for what sounds like simpler explanations. As psychiatrists, we balance innovation with scientific rigor, ensuring that supportive approaches complement, but do not replace time-tested interventions.”
Along this line of thinking, functional medicine may create unnecessary anxiety or treatment plans while striving to find the root of a problem. Some people may not want to take that journey, especially when the cost of that plan includes time and money. - Functional Medicine can give off big business vibes. Treatment with supplements is a big part of functional medicine. The front webpage of FunctionHealth, for example, has two buttons to tap – one to read articles on functional medicine, the other to buy supplements. Most of the interventions for out-of-range lab values in functional medicine are indeed supplements.
Dr. Christian urges patients to “use caution when it comes to using unregulated products. Patients often express skepticism with Big Pharma and I get that. But what about Big Vitamin and Big Supplement? These are multibillion dollar industries with a product to sell. Furthermore, supplements and overuse of vitamins is not without risk. As with traditional medicine, there is the potential for side effects and harm including liver dysfunction, interaction with other medications, etc. Be careful. If it sounds too good to be true, it probably is.”
What do I personally think of functional medicine?
I understand the movement towards wanting to know more and wanting to do more. It’s empowering and feels like we are investing in the extra special care we all deserve. But more doesn’t always mean better.
Buying into functional medicine feels like a promise that a root will be discovered, and that something can be done about it. But this feels like a false promise to me. Not all chronic disease can be identified and solved preventatively. Not all chronic disease can be blamed on inaction of the individual. As frustrating as this may be, the reality is that sometimes there are no roots we can find, there are no answers.
Big personalities, confidence, and dare I say podcasting (often including fear mongering) tend to make people sound like they know what they are talking about. But a big red flag for me is when someone claims a food has the power to either cure or kill us, or when someone claims they have all the answers. Because, let’s be honest, they don’t.
An idea: Perhaps our mindset should be on finding a health practitioner we trust, instead of focusing on whether or not functional medicine is the best way to go. Find someone to build a lifelong relationship with. Someone who will go to bat for you and your needs. Someone who will ride the highs and lows with you.
As the local physicians said above, they are not certified functional medicine doctors but do practice in a way that considers the unique individual and refer out to supportive services as needed. Maybe, in the end, that is what we are really looking for? Someone who cares.
Key Takeaways:
Functional medicine is an approach that aims to identify the root cause of chronic illness, a nuanced difference from a more allopathic or conventional system which focuses on the treatment of disease.
There are pros and cons to signing on with a functional medicine practice, and it’s important to know what you are getting into beforehand.
For questions regarding functional medicine, or if you are interested in personal nutrition counseling, read more about how you can connect with me one on one.
As always, your comments and questions are welcome!
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