Have you recently learned about functional medicine and are considering working with a functional medicine doctor? Or have you been working with a provider but haven’t gotten the results you want? If you answered yes to either of these questions, there is a good chance you could use some help finding a highly skilled doctor who is capable of identifying and addressing the underlying cause of your health issues. Like any field of healthcare, however, it can be challenging to find the right provider for you. Especially in a field such as functional medicine which is still relatively new.
This article will provide you with some tips on exactly what to look for when seeking out a functional medicine provider. By the end of the article, you should have a good sense of which qualities to look for when evaluating different practitioners, and this should help increase your chances of finding someone who can help you get to the bottom of why you’re not feeling well. So let’s jump in.
Tip 1: Consider Credentials
First and foremost, and this probably goes without saying, but you may want to consider the credentials of any functional medicine practitioner you are thinking of working with. The reason I think this is particularly important to pay attention to is because there is no limit on who can claim to practice functional medicine. There is no governing body within functional medicine that regulates who can legally practice functional medicine, and anyone can refer to themself as a functional medicine practitioner.
There are pros and cons to this lack of regulation. The pros are that it allows a wider array of innovative and intelligent practitioners from many different fields of healthcare to get involved in functional medicine. The cons are that anyone, regardless of training, can claim to be an “expert.” This can become especially problematic if someone who lacks the necessary training attempts to work with people who have serious health concerns. It’s also particularly concerning when such a person is also very charismatic and has a dynamic personality that attracts lots of people. Working with someone who is undertrained can be harmful, especially if that person utilizes unproven and ineffective treatments.
To help guard against wasting your time and money on someone who is unqualified, I recommend you seek out a provider who has gone through a rigorous education from an accredited school. Your best bet may be to work with someone who has earned a doctorate degree. This ensures that this person has received a well-rounded education and has had to pass difficult board examinations to prove their competency. There are several types of doctors who specialize in functional medicine including chiropractors, medical doctors, osteopaths, and naturopaths, and all of them have completed an intensive curriculum during their time in school.
I don’t want it to be misconstrued that I’m saying you should only work with a doctor. That’s not at all the case. There are other types of practitioners who are not licensed physicians, but who have received an excellent education and get amazing results with patients/clients. On the other hand, there are also highly credentialed doctors (such as MDs and PhDs, for example) who I have seen promote the use of unvalidated tests and unproven treatments. I am simply saying that working with a doctor may increase your chances of receiving quality care, although it does not guarantee it. Credentials aren’t the only factor to consider, which is why my next several tips should help provide you with further guidance for selecting a good functional medicine practitioner.
Tip 2: Seek Out Someone with Additional Training
Simply graduating from an accredited doctorate program isn’t enough to learn everything that is needed to practice functional medicine. Not even close. For example, one report found that U.S. medical schools only average 19.6 hours total of nutrition education across four years of medical school, and an article from Harvard stated that fewer than 20% of medical schools have a single required course in nutrition. Chiropractors and naturopaths receive more nutrition education in school than this, however it still isn’t adequate for what is needed in functional medicine. Considering that nutrition is the foundation of functional medicine, this proves that additional training is necessary to become a good functional medicine provider.
Unfortunately, there is no standardized education within functional medicine currently. However, it is worth noting that there are several excellent educational programs that truly help people become highly competent functional medicine practitioners. Being a good functional medicine provider requires a great deal of knowledge about certain aspects of health that aren’t taught in conventional medical education. For this reason, it is probably best that you select a functional medicine provider who has additional training that is specific to functional and integrative medicine. This training could be a degree related to nutrition or functional and integrative medicine (such as a Master’s degree or PhD), or it could include specific certifications from the Institute for Functional Medicine or similar programs.
Another thing to be aware of is that some practitioners claim to be “self-taught.” While it is theoretically possible to be a self-taught functional medicine practitioner, it is very unlikely that most people who make this claim have dedicated the necessary time to cover all their bases in terms of increasing knowledge about the various topics/areas in functional medicine. A functional medicine provider should have in-depth knowledge about many areas of health (such as the gut, immune system, hormones, metabolism and energy production, detoxification, exercise, nutrition, and much more) and this knowledge must be well above and beyond what is taught in a conventional 4-year medical education program. Someone who is self-taught and who hasn’t gone through a structured program in functional medicine will likely have a hard time navigating the complexities of all of these areas of health, and they may not have been exposed to the full scope of what there is to know about functional medicine.
Tip 3: Seek Out Someone Who Values High Quality Research
This may be the most important tip in this article because practitioners who value high quality research in their clinical decision making are much more likely to get better results with their patients than practitioners who don’t value high quality evidence or who don’t pay attention to research at all. You may be wondering what distinguishes high quality research from low quality research. In simple terms, high quality research includes studies that are performed on humans and isolates certain variables to determine if and when a specific treatment or test is appropriate and most likely to work. In contrast, low quality research includes studies that focus on one particular mechanism or biochemical pathway, and these studies often take place in animals or in a carefully controlled laboratory setting. This type of research is interesting, but it isn’t very applicable to actual human patients.
One mistake that practitioners can sometimes fall into is placing too much value on low quality research, and then using the findings from this research as a basis for recommending a particular lab test or treatment protocol that isn’t actually effective in humans. This can result in a lot of frustration from patients because they aren’t getting the results they want. It can also be very disappointing for practitioners who most likely have good intentions and want to help all their patients improve.
Something that you can do to ensure you find an evidence-based practitioner is to find someone who has a website, blog, podcast, book, or social media channel that regularly references peer-reviewed research. You can even seek out someone who has published research in medical journals themselves. If a practitioner doesn’t happen to have any research-based materials that you can reference, but still seems very intelligent and competent, you can verify this by listening to the way that they speak to you. For example, someone who cites facts and statistics that can be fact-checked is much more likely to be a quality practitioner compared to someone who makes idealistic claims and speaks in generalities. And speaking of making claims, this leads me to my next tip…
Tip 4: Seek Out Someone Who Isn’t Dogmatic
It is very important to find someone who isn’t dogmatic and doesn’t think in “black and white” terms. An example of this type of thinking would be someone who makes claims such as “nobody should eat gluten EVER” or “everybody MUST take 10,000 IU per day of vitamin D.” When someone speaks in such absolute terms, it is a huge red flag in my opinion. Speaking in this manner demonstrates a lack of understanding and appreciation for the uniqueness of every individual. Everyone has their own unique genetics, diet, lifestyle, environment, experiences, and beliefs, and all of these factors can influence health. Making sweeping generalizations fails to take into account the uniqueness of each individual, and may lead to “cookie-cutter” approaches that aren't personalized and don't address the underlying cause of the problem.
Additionally, being dogmatic and overly attached to certain viewpoints can make it difficult to update one’s views when new data becomes available. Science is constantly evolving and new research is always being published. It is very important for clinicians to be adaptable and willing to update their viewpoints and approaches based on the best available evidence. This is why I recommend you opt for a practitioner with nuanced opinions. Practitioners who appreciate the intricacies of healthcare and research are much more likely to make the right recommendations for their patients at the right times.
Tip 5: Seek Out Someone Who is Cautious with Lab Testing
Most functional medicine practitioners recommend lab testing to assess your health and help identify the cause of your symptoms, and the recommended testing may include conventional and/or functional labs. Conventional labs include tests that you have probably seen at some point in your life. Some examples include a complete blood count (CBC), comprehensive metabolic panel (CMP), or urinalysis. In addition, so-called “functional” lab tests may also be recommended. These tests are often a major selling point for functional medicine because they claim to look more deeply at how your body is functioning, and to help identify the root cause of your symptoms. Tests such as these may sound like a godsend, especially if you’ve been sick for a long time and doctors keep telling you that your conventional labs are normal. However, things can get tricky because not all lab tests are created equal.
The important thing to understand with functional lab tests is that some of them have merit while others are unnecessary and not scientifically validated. For example, certain stool tests appear to provide clinically useful information that can indicate if you have an imbalance or infection in your gut that is driving your symptoms. In contrast, one commonly used test in functional medicine that involves measuring urine cortisol levels in people with chronic fatigue is likely a waste of time because cortisol levels don’t correlate with fatigue symptoms in most cases [1]. I’ve also previously written about food sensitivity testing, which is another common type of test used in functional and integrative medicine that is not validated.
These examples help illustrate how functional labs can be hit or miss. Another factor to consider with functional lab tests is that they are often quite expensive, and are usually paid for out of pocket. Despite the questionable utility of many of these labs, some practitioners who aren’t aware of the limitations of these tests may recommend that you pay thousands of dollars up-front for numerous functional lab tests. This approach to lab testing can be problematic, especially if several different lab markers come back abnormal and the practitioner places too much focus on treating the labs and not enough focus on identifying and addressing the root cause.
For the above reasons, I recommend finding a functional medicine provider who is conservative with lab testing, and who places a strong emphasis on conducting a thorough health assessment. A clinician who is skilled in performing a good health assessment and taking a thorough health history will be able to identify the factors that are most likely to be contributing to your symptoms. They are also more likely to guide you through a personalized and research-backed approach in a systematic manner. This type of approach is more likely to yield the greatest benefits for your health at the lowest cost, and it avoids the problem of over-testing and over-treatment.
Final Thoughts
If you’ve read this far, there’s a good chance you’re seriously considering trying a functional medicine approach, and I want to commend you for taking the necessary steps to improve your health. Functional medicine, when done properly, can yield some truly amazing results for patients and help address the cause of symptoms rather than simply masking them.
I’m confident that if you follow the above recommendations you’ll be able to find a highly competent practitioner who has your best interests at heart. It may take a bit of time and research to find that person, but once you do you’ll be well on your way to feeling better and living a more fulfilling life. Also, don’t forget to listen to your gut when making your decision. Many practitioners now offer free phone consultations which can give you the opportunity to speak with them directly and understand their approach. If you speak with a practitioner and don’t have a good feeling about working with them, simply move on and try someone else. There is no shortage of practitioners, and now that telehealth is becoming more and more common, your ability to work with a doctor you like doesn’t have to be limited by where you live.
In health,
Dr. Vonfeldt
If you're interested in trying functional medicine, check out my clinic by clicking here.
Comments