The Intersection of Osteopathic, Family and Functional Medicine

What few words come to mind when you think of an Osteopathic physician? Possibly holistic, hands-on, or even innovative? What about descriptive words that define a Family physician? Certainly, words like relationships, preventative, or leader. What about another variety of physician that combines features of both, Osteopathic and Family medicine, but with a new and more progressive ideology?

In recent years, a more progressive dimension of medicine has been growing in popularity among a particular segment of patients. These patients are mostly healthy, with maybe only one or two chronic conditions that are well managed. These same patients are active in their health management and have an impactful voice in their overall health outcomes. They aren’t genuinely interested in an easy fix, but instead they strive to get to the bottom of their health concerns. This collaborative discipline is known as Functional Medicine.

“Functional medicine is a systems biology-based approach that focuses on identifying and addressing the root cause of disease. (1)” Functional medicine doesn’t just aim to treat symptoms, but to also address the underlying cause of one’s symptoms. Through root cause analysis we can solve more health issues, and not just Band-Aid them until next time.

Let’s consider mild constipation, as an example. Often times, in the rush of the day, we may find ourselves just treating the symptom - constipation. We recommend a stool softener or maybe a pro-kinetic agent. The patient is happy, we are happy, and onto the next we go. Until the patient becomes symptomatic again, and possibly worse this time. We escalate our treatment plan in order to now treat moderate constipation. And so the cycle continues, chasing the symptoms once they present yet, never really solving the patient’s problem.

How might constipation look different through the lens of Functional medicine? We might ask more questions about the patient’s diet and discuss how fiber and hydration are important in the regulation of bowel movements. Maybe we ask about the patient’s current mental health status and educate them on how fluctuating levels of neurotransmitters also affect the gut. What about microbiome maintenance and how to make sure the patient understands that healthy gut bacteria ensures optimal digestion. We must also have clarity regarding the patient’s environmental factors, occupation, medical history, and lifestyle. These are just some of the paths that a functional medicine physician might explore with their patient, while working to remedy their health concerns. If we can determine the underlying issue(s) causing the patient’s constipation, then we can more efficiently and effectively solve the problem.

So why, as Osteopathic Family physicians, should we embrace the concept of Functional medicine? Ultimately, it offers our patients the best long-term outcome. Functional medicine also represents the definition of holistic, innovative, and preventative care. By getting “root cause” answers for our patients, about why symptoms are occurring, we engage them to take an active interest in their health. Fostering a community that feels empowered to collaborate with their physician regarding one’s care will lead to healthier lifestyles and a more thriving community population.

The one notable drawback to Functional Medicine is simply time. Taking time with a patient to listen and assess their issues in a diligent and tenacious manner, isn’t always practical in today’s medical service model. Time is also critical in gaining patient trust, as a partner in their journey to better health.

My challenge to Family physicians, who are interested in taking a more results-oriented Functional medicine approach, is to start small and routine. Use the root cause reasoning for acute care visits regarding issues such as migraines and constipation. Test and measure whether patient satisfaction and health outcomes improve with a functional approach and take notice if repeat visits for the same symptom(s) decrease. Engage with your patients, listen to their stories, and allow time to be your friend and not healthcare’s enemy.

The intersection of Osteopathic, Family, and Functional medicine has the power to change the doctor-patient relationship and healthcare at-large, in a way that yields more promising and long-term results for patients and their opportunity to thrive. For more information on Functional Medicine, check out the Institute of Functional Medicine website at www.IFM.org. (1)