Over the years there’s been a number of different terms used to attempt to define the type of healthcare that uses nutrition or lifestyle as the primary modifier, with heroic interventions such as surgery being reserved as a last resort. Preventive, holistic, alternative, complementary, and on and on. These terms were generally used to differentiate that approach from “mainstream” or “conventional” medicine, which is generally thought of as “what’s taught in most medical schools today.” Unfortunately, what’s taught in med schools today leaves out a pretty broad segment of practitioners, such as chiropractors, acupuncturists and herbalists, to name a few, which, frankly had been often dismissed by their more mainstream brethren as, at best, misguided, and at worst, as outright quacks. But since David Eisenberg revealed that more money was being spent by patients out-of-pocket for these “unconventional” treatments than for the therapies taught in med schools, a lot more attention (and indeed, acceptance) has been directed toward these options.

Additionally, there’s been a change in what needs to be treated. Infant mortality is not nearly as prevalent today (at least in most first-world countries) as it was 100 years ago; an injury or wound isn’t a virtual death sentence any more, largely because of improved techniques (think Semmelweis) and powerful antibiotics (think Fleming). What’s killing people today (cancer, cardiovascular disease, diabetes, obesity) lend themselves to a much different approach; one that focuses on lifestyle and nutrition much more than a surgical intervention or single pharmaceutical agent.

So what do we call this new type of medicine? It’s tempting to just call it “good medicine” and be done with it, since whatever works to benefit the patient should be considered that. But in the early ’90’s, Jeff Bland began promoting the concept of improving the function of the patient as the proper point of focus. Find out what underlying mechanisms were contributing to the phenotypical outcome. To say it differently, elevated blood sugar is an effect as much as a cause of the patient’s problems. True, elevated blood sugar causes changes in kidney function, retinal scarring and so forth, but why is the blood sugar elevated in the first place? It’s not just insufficient insulin (although that may be part of it), but cellular recognition of insulin (as in type 2 diabetes) has to be investigated. What role does inflammation play? And what is triggering that inflammatory process?

Again, a simple (and single) pharmaceutical intervention is not the answer. Investigating and understanding these underlying mechanisms leads to a greater respect for the function of the body, along with strategies to restore that function to a more healthy state.

And so “Functional Medicine” as a discipline as well as a overarching strategy was born. This blog is meant to both honor that vision that Jeff has been promoting so tirelessly for the past 30 plus years, and at the same time explore some of the nuance and tactics that underpin it. I’ve been actively involved in this profession (from the business side for over 40 years, and have had the privilege of knowing and working with hundreds of dedicated healthcare professionals. It is my goal to share their observations and experiences, as well as my own on this blog. There is obviously orders of magnitude more information than can be adequately explored here, but hopefully I can add a little to that conversation.

I hope you feel inclined to participate in this conversation; please send me your thoughts and experiences (both positive and negative). I will do my best to incorporate your thoughts and suggestions, but as I’m sure you understand (since this is my blog and all), I reserve the right to post (or not) and my decision is final.