Functional Medicine
Functional medicine is a term that has been stretched far enough to cover both careful physician-led care and some things that deserve a great deal of skepticism. This page is about telling them apart.
Dr. Massinople is a board-certified physician with over 25 years in clinical practice. What follows is her read on the field, including the parts of it she would warn you about.
What it actually is
A conventional appointment asks what the diagnosis is and which treatment matches it. That works extremely well for a great many problems and nothing here suggests otherwise.
It works less well when someone has six symptoms across four body systems, every test comes back normal, and no single diagnosis fits. That person gets referred to four specialists, each of whom reasonably finds nothing in their own area.
Functional medicine asks a different question. Not what the label is, but what is actually driving this, and in what order should it be addressed. It treats sleep, blood sugar, nutrition, gut function, muscle, stress load and hormones as the substrate everything else sits on, and it allocates enough time to work through them.
What it is not
It is not alternative medicine. It is not a replacement for your primary care doctor, your cardiologist or your oncologist, and a good practitioner will tell you when something belongs with one of them.
It is not a reason to stop a prescribed medication. It is not a philosophy that all illness comes from one cause, whatever that cause is this year. And it is not a shelf of supplements.
The honest problem with the field
The term is not protected. Anyone can use it, with any level of training or none, and plenty do. That produces a wide spread of quality under one label, and it is the main reason thoughtful people are suspicious of the whole thing.
Some of that suspicion is earned. There are practitioners running expensive panels that cannot change a decision, selling branded supplements at margin, diagnosing conditions that do not have agreed diagnostic criteria, and telling people to stop medication they need.
So the useful question is not whether functional medicine works. It is how to tell which practitioner you are dealing with.
How to tell good from bad
Signs you are in good hands
- They hold a recognized clinical license, and you can verify it with your state board in about two minutes
- They ask what else you are under the care of, and want to coordinate rather than replace
- Every test they order has a stated reason and a stated consequence
- They tell you what they do not know
- They refer you out when something is outside their scope
- They talk about sleep, food, movement and stress before they talk about products
Signs to walk away
- A large panel ordered before anyone has taken a proper history
- Supplements sold in house, particularly own brand, particularly in quantity
- Any suggestion of stopping prescribed medication without involving the prescriber
- Diagnoses that no two practitioners define the same way
- A fixed multi-thousand package required before you know what is wrong
- Certainty. Nobody honest is certain about this much
Who it suits
People with several symptoms nobody has connected. People whose labs keep coming back normal. People who have been handed a prescription that manages a symptom without anyone asking why the symptom is there. People who want the time to work through it properly.
It suits far fewer people than the field claims. If you have a clear diagnosis with an effective conventional treatment, that treatment is the answer, and a good functional medicine physician will say so.
Dr. Massinople's own writing on this: what functional medicine actually is, why your labs are normal but you do not feel normal, and why doing more is not making you feel better. Or see the two ways to work with her.
