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             What is the Medicine of the future?       Jan 2nd 2015

 

We are beginning a new year. This is a time when we review the acheivements of the past and make resolutions to make changes to develop and prepare ourselves for the future. This is also a time when health care is undergoing a lot of change. There is a new model of approaching health, wellnes and disease. The Functional Model is replacing the conventional model. This change is being driven by both evidence and research as well as by patients who are more educated, aware and motivated to take charge of their own health. Below are some fundamental differences between the conventional and new models.

 

                Conventional Model                                                  Functional Model

 

                             1. Whole is greater than the Sum of its parts

 

 

 

 

 

 

 

                                                     

 

 

 

 

A conventional physician treats an area of the body for example if a patient has sinusitis then it is a disease of the sinuses. It is assumed that the disease is present in one part of the body.

In a functional approach, sinusitis is an indication of inflammation in the body. This inflammation in one part of the body will also be present in other parts of the body because every cell communicates with other cells in the body and every organ communicates with other organs so a problem in one part of the body will also create problems in other parts of the body. So the physician will look at the person as a whole.

2. Causality: The principle that everything has a cause

3. We are all born originals’ (Edward Young)

4. ‘The good physician treats the disease; the great physician treats the patient who has the disease’ (Sir William Osler)

5. Nature is the best medicine.

6. Prevention is better than cure

In conventional medicine, the first step is making the diagnosis. An example is Diabetes and high blood pressure. Once the diagnosis is made, these diseases are controlled through the use of medications that alter certain processes in order to control blood sugar and blood pressure. We are not asking the question as to why the blood pressure and cholesterol are elevated in the first place.

In functional medicine, the first step is to determine the cause of the problem and correct the cause rather to merely control or reverse the effect. There are many causes why a person can develop high blood sugars including diet, lifestyle, hormones, stress, sleep, environmental toxins etc. If we can find and reverse the cause we can potentially control blood sugar and prevent the complications related to high blood sugars.

Conventional treatment of a disease is the same for everyone irrespective of their height, weight, intellectual and emotional capacity, genetics, physical characteristics and past medical history.

Functional medicine considers each individual to be unique not only genetically but also physically and emotionally. We all have a unique microbiome and a unique path from the time of our birth. All these have played in a role in the development of the disease and all these need to be addressed when treating the disease.

In conventional medicine, the purpose of treatment is controlling the symptoms of a disease. For example using inhalers to control symptoms of asthma. 

In functional medicine, the purpose is to remove the triggers or factors predisposing the patient to suffer from a health problem. An example is insomnia. Instead of prescribing tranquilizers if we can find out the cause of insomnia then we can avoid the serious side effects of tranquilizers as well as save money and gain more control of our lives.

According to the World Health Organization 2004 report, USA consumes around 52% of the medications produced in the entire world. Unfortunately medication associated adverse events increased by 52% from 2004 to 2008. In 2008 1.9 million people were hospitalized and 838,000 visited the emergency rooms due to adverse drug outcomes including deaths. Despite use of excessive medications, the burden of chronic disease continues to rise steadily.

An important characteristic of the human body is its ability to protect and heal itself. A functional physician facilitates the patient to develop and optimize their innate immunity. In addition to using conventional treatments, there are many natural treatments that are evidence based and effective in preventing and treating the cause of the disease. 

Conventional medicine model is an effective model for treating emergency conditions like a heart attack or stroke. This model is not designed for optimizing wellness and preventing the development of disease. Most chronic diseases like heart disease and cancer take years to develop. The patients may have non-specific symptoms or no symptoms during this time. Conventional medicine lacks a frame-work to prevent chronic disease development. 

The functional paradigm is designed for wellness and prevention. It focuses on preventable factors including lifestyle, stress, nutrition, environmental exposures, hormonal metabolism, microbiome and microorganisms to assess the risk of diseases, prevent disease and sustain good health.

References: 

1.WHO Report: The World Medicines Situation http://apps.who.int/medicinedocs/en/d/Js6160e/6.html#Js6160e.6

2.Health care cost and utilization project by Agency for Healthcare Research and Quality (AHRQ). April 2011                                                           http://www.hcup-us.ahrq.gov/reports/statbriefs/sb109.pdf