Functional Medicine is an Idea Whose Time Has Come
Functional Medicine is a natural shift from prescientific perspectives on health and disease to modern science-based medicine. All “good medicine” rests on the basic principle of first making a good diagnosis before providing a logical treatment. All good non-fiction rests of using terminology which conforms to definitions from authoritative sources such as Webster’s dictionary. Unfortunately when terms such as “diagnosis” have multiple and completely different definitions, a great deal of confusion can result. We must define what we mean by the term diagnosis, before we can define what “good medicine” even is.
Diagnosis can mean: 1) to describe the outward appearance of something or it can mean: 2) to define the cause of a condition. If my brakes don’t work well or squeak, not knowing much about auto mechanics I could diagnose the problem as malfunctioning brakes that make funny noises (first definition). I don’t know the cause of the problem (2nd definition), but at least I can diagnose the outward malfunction. Diagnosing the cause of the malfunction requires consulting a professional who knows something about the technology of cars, a trained, experienced mechanic, who can, based on defining the cause, “cure” the problem.
For thousands of years doctors diagnosed pneumonia in their patients based on its appearance; fever, chills, cough, sputum production, chest pain etc. They designed treatments without knowing the cause. With technological advances such as development of a microscope and the germ theory, doctors were able to move from a prescientific diagnosis of pneumonia to a science-based one and define the cause of the respiratory symptoms. Pneumonia came to be labeled Pneumococcal Pneumonia or Streptococcal Pneumonia depending on the specific causal organism. Movement towards diagnosing the specific cause of pneumonia led to searches for substances to inhibit the causative germs such as antibiotics, and cures of the dreaded disease were possible.
What about the diagnoses of fibromyalgia or depression? Are these merely descriptive, prescientific diagnoses or causal, science-based ones? Obviously they fall into the former category. But with all of the astonishing scientific knowledge available, why would we make such diagnoses based on the older system, simply describing the outward appearance of these disorders? Were a medical professional to diagnose pneumonia in their patient in this way, as fever, chills, cough, sputum production, chest pain etc., and leave out a diagnostic assessment of the germ causing the symptoms, they could suffer humiliation from their peers, lawsuits from their patients and licensing disciplinary actions.
The reason that the accepted standards of mainstream medicine care permits physicians to use the merely descriptive diagnostic terms fibromyalgia and depression is because a single cause, like a germ, has never been found for them. Like heart disease, which is causally related to risk factors like high cholesterol, diabetes and hypertension, fibromyalgia and depression each have dozens of causes.
One definition of diagnosis is to establish the cause, a singular term, and there is no word in the English language for a “multidiagnosis,” so most physicians are basically content to fall back on the pre-scientific definition of “diagnosis” and simply describe the outward appearance of these disorders instead of going on to define their biochemical, toxicological, hormonal, metabolic and genetic risk factors which peer-reviewed, scientific studies suggest actually exist.
That is precisely the issue which defines Functional Medicine, an approach to patient care which is unwilling to merely describe the outward appearance of many syndromes and diseases, but instead moves on to a science-based search for the actual, causal factors in every patient. Like the first, brave physicians who assumed, based on rather meager evidence by today’s standards, that enough scientific evidence had accrued to suggest that germs do indeed cause certain diseases, so to do Functional Medicine clinicians believe that enough biochemical, toxicological, hormonal, metabolic and genetic risk factors have been causally linked to the syndromes of fibromyalgia and depression, that they can diagnose these conditions, and in fact all medical and psychiatric, from a science-based position rather than a prescientific description.
Today we applaud the early adherents of germ theory who pioneered science-based medicine and we consider their critics to be buffoons deserving of humiliation. Someday, the current, fear-based, critics of Functional Medicine clinicians, who like the early detractors of the germ theory, will also be the subject of humiliation and disgrace. Over a billion human beings perished in the 19th century from tuberculosis alone, in part because large groups of physicians could not see the obvious, or if they did see the truth, were unwilling to risk their social and professional status by admitting it.
Today, we see the same forces at work. Physicians join together into groups and organizations to promote obsolete models of treatment and most fail to be willing to take a stand again officially-accepted but false doctrines. The most outstanding of these “sacred cows” is the diagnosing of most chronic medical and virtually all psychiatric disorders as prescientific, descriptive entities rather than as science-based and thus curable disorders with definitive causes. Unfortunately, like the billion lives lost to Tuberculosis, the consequences of this intransigence are unfathomable human morbidity and mortality from chronic disorders.
Which category of physician do you want to be classified in by your descendents , the science-based one who paved a path to healing like the first germ theory adherents, or the intransigent, anti-science category of doctors whose irrational resistance harmed and killed millions?
I know the answer to that question and so do you.
Functional medicine is an idea whose time has come.