What is Functional Medicine? And is it more cost effective?

What is Functional Medicine?

Functional Medicine looks at the root cause of problems. It identifies and prevents problems that could lead to disease.

Functional Medicine vs Conventional Medicine

Functional Medicine identifies symptoms and investigates to find the root cause of the problem. Not only does functional medicine dig, but the treatments target the exact root of the issue that patients are experiencing to help stop the spread of symptoms before they lead to disease. Often times patients will have exhausted conventional medicine methods of treatment before seeking a functional medicine provider. And, at this point in this patients disease process, will the functional medicine provider be able to help with symptoms and treat the actual disease by further digging. The methodology of functional medicine looks at investigating problems through a series of tests followed by treating with specific protocols or lifestyle changes and it really works!

Do we still need conventional medicine? Yes, we need conventional medicine to help us with acute and emergent needs, but conventional medicine does not do a great job at preventative medicine. I have spent a majority of my career in the emergency department where I have helped patients with their acute needs. However, what I have found is that majority of the problems patients were being seen for, were problems with illness that could have been preventable. Conventional medicine practices do not do a lot to prevent illness. The main focus is on trying to get patients treated when they are already ill. The foundation of functional medicine is that it identifies and looks at the root cause of illness.

Functional medicine may seem expensive, but in reality it is cheaper than conventional medicine.

Functional medicine can seem to put a dent in your wallet at first but in reality, functional medicine prevents patients from overspending on prescriptions, surgeries and other procedures in the long run. This method of health care is actually more cost effective. As an example, which I have seen time and time again- A patient enters the emergency department with a problem related to diabetes mellitus type 2, their blood sugar is critically elevated and they cannot seem to lower it. They were not counseled on exercises that can help combat the disease. They were not counseled on lifestyle changes, instead, their primary care provider diagnosed them and wrote a prescription with a handout on how to make lifestyle changes. The patient lost the handout or never bothered to read it. What happens next? Patient gets hospitalized, and treated, patient gets billed thousands.

An experienced functional medicine provider will look at the patients diet and lifestyle and work with the patient collaboratively to reach their health goals. However, there must be understanding that this takes time and multiple visits to achieve the best outcome for the patients’ health.

The problem with insurance

Insurance premiums have skyrocketed and employer contributions are decreasing exponentially! In fact, according to ehealth, “ In 2020 the national average health insurance premium for an ACA plan is $456 for an individual and $1152 for a family.” Not only are premiums high but “the average annual deductible for single, individual coverage is $4,364 and $8,439 for family coverage.” This means that the patient and their family must pay these obscene amounts before their insurance even kicks in to cover the actual costs! Making matters worse, the care received by most do not address the root cause of issues, most of the visits just include basic medication refills, quick annual exams and basic labs. So, we can pay for medical insurance that gives us some coverage for sub-par healthcare, have extra costs of medical visits and/or procedures and still be on a lifetime of medications.

In reality, health insurance is a must for acute needs and to help cover some visits, but it does not help cover prevention which seems like a loss. I'm no expert on the insurance and out of pocket paradigm, but in my experience, patients do well by continuing to pay their insurance premiums, and instead of coming out of pocket in order to meet deductible, they find healthier alternatives with their expenditures by seeking answers with a functional medicine provider which, in the long run, lowers their chance of increasing costs of hospitalizations, medications, or procedures.