Functional and integrative medicine is increasing in popularity amongst both patients and practitioners. Unfortunately, there are no "degrees," no overseeing national "board," or no rules for who can call themselves a functional medicine practitioner. This makes it difficult for patients who are seeking good care, and for functional medicine practitioners that are practicing "real" functional medicine but have to deal with the colleagues that are giving functional medicine a bad name. I believe that every practitioner means well, but there are some that are misguided. Hence, the need for a list of "red flags" to ideally weed out the really good practitioners from those that still need some guidance!
Avoid practices that participate in the following:
- They don't listen to the patient, particularly the details of the patient's story. The detailed medical and environmental history is what guides treatment (and in functional/integrative medicine, this includes details such as dental history, trauma, moving to a new residence, and more).
- They tell patient that their way is the best/only way to treat.
- A patient leaves the appointment feeling frightened or pressured instead of hopeful.
- They promise "cures" and are very opinionated/dogmatic about what "everyone" should be doing for optimal health.
- They prescribe a long list of supplements, and tell patients that the brand doesn't matter, or they don't give a dose recommendation, or they tell patients that their company/brand is the only one you should use.
- They don't address gut health and lifestyle habits first and foremost (even if that practitioner practices in a "specialty" such as hormone replacement). These are the foundations of health! One of the most common mistakes I see practitioners do is recommend a lot of supplements based off lab results. From my experience, labs looking for micronutrient deficiencies should not be run until nutrition is improved/optimized for at least 6 weeks. Once a lab is run, if there are a significant number of deficiencies, this doesn't necessarily mean that a patient isn't taking in enough - it often indicates that there is maldigestion/malabsorption that needs to be addressed.
- They don't address the specifics of a patient's diet, or say "everyone" should stay away from certain foods for life (or worse - they tell patients that diet doesn't matter). They focus on supplements/medications/medical "foods" as the best/only way to treat symptoms or chronic disease. Granted, many clinicians don't have the time or desire to educate patients on this topic. In this case, they should at least be referring patients to a qualified health or nutrition coach.
- They recommend cookie cutter "detox" or "cleanse" programs, with lots of supplements. Personalized therapeutic programs, based on symptoms and lab results, are the best method for true functional medicine care. And many patients may need some supplements, but supplements are intended to either be "therapeutic" (i.e. temporary use) or "supplement" a good diet/lifestyle (not replace it!).
- They are not up front and transparent about costs (or sensitive to patient's financial situations).
- They order a bunch of tests ("shotgun" approach) but don't prioritize or tell patients why they need to be ordered, or how the results can change a course of treatment. It's fine to recommend the tests, but more testing does not equal better results. In conventional and functional medical practices, practitioners are often too focused on "treating the labs" rather than "treating the patient" - even though this phrase is repeatedly taught in our training!
Consider these "red flags" if you are a practitioner (in any practice of medicine), or you are a patient. Finding the right fit for both a patient and a practitioner is like dating - you may have to "date" a few practitioners before you find the right one! If you are looking for a practitioner that has received functional medicine education, I recommend starting with the Institute for Functional Medicine practitioner directory. And if you are a clinician looking for training, check out the resources page on this website.
Wishing everyone good health!