Medicine in general seems to be adopting more of this holistic mindset. “It’s thought that Western medicine treats disease, while functional medicine treats the person as a whole,” Brynna Connor, MD, a board-certified family medicine physician and healthcare ambassador at NorthWestPharmacy.com, who does not practice FM, tells SELF. “But I do believe this has changed significantly in the last few decades.” Case in point: It’s much more common now to find multidisciplinary clinics where you can be treated for concerns like skin conditions and autoimmune diseases where practitioners offer a range of traditional and holistic approaches under one roof.
The downsides to look out for
All that said, there are vocal critics of functional medicine and minimal research examining the practice. For example, the Cleveland Clinic published a study in 2019 saying it was “the first retrospective cohort study of the functional medicine model.” That’s pretty recent to just be the first study of its kind. Prominent science writers have called FM “quackery” and “pseudoscience.” For several years, the American Academy of Family Physicians (AAFP) did not allow physicians to take FM courses as part of their continuing medical education requirements, and now it only allows overview courses rather than courses that teach the techniques. (The AAFP declined to participate in this article, as did the American Medical Association.)
Broadly, tenets such as prioritizing nutrition, individualizing care, and getting enough sleep are hard to disagree with. “However, the problem is that the application and adherence to its principles is very variable,” Dr. Ballard says.
Some providers, for example, put patients through a battery of tests, including measures of gut function, hormone levels, immunity, and nutritional deficiencies that aren’t typical in conventional bloodwork. There may be different ways to interpret the results of some of those tests or few actionable steps to take based on the results, Dr. Ballard says. Plus, because those tests are typically not standard care, they aren’t usually covered by insurance, Dr. Payrovi says.
Because FM operates outside of the current standards of American healthcare, there’s a chance providers will recommend treatments that aren’t supported by scientific evidence. “The main risk that I see with functional medicine is the potential for patients to be sold various types of trending therapies that simply don’t work,” Dr. Generales says.
And of course, some supplements simply don’t work, either. FM is known for relying on these alternative remedies, but “there’s potential harm in giving supplements that are in place of pharmaceuticals, or giving too many supplements,” Dr. Carter says.
Lastly, FM is not the right approach “during acute emergencies, such as heart attacks and strokes,” Dr. Generales says. And it could be dangerous if you’re being treated for other serious conditions already. “If you are undergoing cancer treatment, or take a number of medications for blood pressure, cholesterol, or diabetes, [for example,] it is important to discuss supplements with your doctor to ensure the functional medicine supplements are working alongside your well-studied Western medications to improve your overall health,” Jessica Lee, MD, an internal medicine physician at the University of Maryland Medical Center who does not practice FM, tells SELF.
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