Cost of Functional Medicine

Posted on by Meg McElroy MS, PA-C

So much of our lives is based on money.

When it comes to health care, I wish the cost of functional medicine didn’t deter people from seeking a functional medicine practitioner.  But the truth is that compared to the perceived up-front costs of mainstream insurance-covered medicine, functional medicine is expensive.  If a patient is paying over $500 to an insurance company each month, and sees a mainstream health care provider, where they pay a $10 copay, they will expect good care.  Often it is forgotten that they only get 15 minutes with the provider, and that there will usually be another bill a few months later, when insurance chooses what will be covered and what will not be covered.

But these perceived up-front costs is where we should stop the financial comparisons.  Let’s start with some important points to make when it comes to the cost of functional medicine:

  • First, we either invest in your health through prevention (when we are able to live a good quality life), or to manage poor health (when you are more likely to be limited by physical and mental obstacles resulting from poor health choices)
  • Second, many people have 401k’s, new homes/cars/iPhones/clothing, attend concerts and sports games at hundreds of dollars per event, but balk at paying for health care.  If someone truly wants to live a thriving lifestyle (and do all the aforementioned), investment in health needs to become a priority (maybe at the initial expense of downgrading other aspects of modern life).
  • Third, because of the monthly cost for health insurance in America (which doesn’t cover many, if any, medical visits), this leads to an entitled mindset (“I pay a lot of money for insurance – I should get my money’s worth”).  But that money we pay monthly to an insurance company is not paying for us to receive healthcare – it’s paying for the “just in case” scenarios of health. Insurance is meant to insure us from accidents and acute health problems.
  • And finally, what I’ve seen in practice is that a patient comes to me having gone through hundreds if not thousands of dollars on the latest supplement/diet/detox/home lab test (all purchased because of good marketing and without a clinician’s recommendation).  But they would have been better off spending this money on good healthy foods, which are the foundations of good health.

Taking into account the above information, the following is a brief guide for patient’s that are seeking out the care of a functional medicine provider.

  • First, weed out the practitioners that have “red flags“.  Not all doctors/lawyers/[insert title] are created equal – neither are functional medicine practitioners.  A patient may even have to shop around before finding the right fit.  An IFM (Institute for Functional Medicine) member is the best places to start, since this organization provides in-depth training and provides a listing of practitioners.  There are other great educational organizations as well, but the IFM is a good first step if a patient is new to functional medicine.
  • Second, determine where you are currently spending your money.  Is it on supplements?  Material belongings? Social gatherings?  If health is not in the top three, re-evaluate your priorities.
  • Third, many functional medicine practitioners spend hours on each patient outside of the one-on-one appointment, looking at the latest scientific research and utilizing colleagues, to ensure high quality care.  So although a patient may only get an hour with a provider one-on-one, they are actually likely to be getting hours of care in that one hour (unbeknownst to the patient). In a mainstream medical practice, a provider’s time outside of a one-on-one patient visit is usually spent on charting and arguing with insurance companies for coverage of a procedure or visit.  One of the many reasons functional medicine providers often won’t work with insurance…
  • Fourth, an insurance company isn’t making the decisions (i.e. what test or medicine will be covered), the patient and the practitioner get to make this decision.
  • Fifth, consider that functional medicine is a business, and that $300 you spend on a visit has to be dispersed towards overhead costs, malpractice insurance coverage, and continuing education.  The practitioner may only end up profiting $50 of those fees, yet spend hours on your health – how many insurance-covered providers are able to be that dedicated to improving your well-being?

So the next time you balk at the costs for providing functional or integrative medical care, consider the above.  And don’t be afraid to ask the provider everything that goes into the costs!  If a clinic is selling a $10,000 year long program, find out what this covers.  It may cover 50+ hours of work on your behalf, supplements, labs, one-on-one nutrition visits, and more.  My tip: I always say a good rule of thumb is to assume that only 1/4 to 1/3 of that cost actually goes to the practitioner (after paying for overhead, taxes, and more).  And with the right practitioner, this can be life changing for a patient’s health and the health of their loved ones!

Wishing everyone good health, happiness, and a life at ease,

Meg