Health and Wellness

New Paradigm Medicine

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You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete.”

– Richard Buckminster Fuller

In the 20th century, medicine developed in an environment of infectious disease, the most common ailments of the day. Mankind made significant progress against eradicating these diseases, from battlefield scars that would turn septic and end a life prematurely to other serious acute diseases. All of the communicable diseases, like typhoid, tuberculosis, and many of the great plagues, were wiped out by a combination of sanitation, nutrition, and basic medical care. We got very good at treating acute disease.

Then a new reality started to emerge—21st century diseases. Now there’s a ridiculous amount of non-communicable disease and estimates are that we will spend $47 trillion over the next 10 years fighting it. Diseases like type 2 diabetes, heart disease, and autoimmune diseases are growing at rapid rates. What we have now is a very different burden of disease with a lot of non-communicable chronic diseases driven by lifestyle and environmental factors. Medicine has been slow to adapt to its new environment, and as a result, chronic disease is set to bankrupt the masses—patients, businesses, and sovereign nations.

Networking before the Functional Forum, New York City, December 2015
Networking before the Functional Forum, New York City, December 2015

We started our business, Evolution of Medicine, in 2014 on a mission to help medicine adapt to its current environment.

The first thing we did was to produce a show called the ‘Functional Forum.’ We’ve made over 30 episodes that are available the first Monday of the month on our YouTube channel, www.youtube.com/FunctionalForum. Over 200 meetup groups of doctors worldwide get together to watch the show.

In our August episode, we covered the International Congress of Integrated Health and Medicine in Stuttgart, Germany. It focused on the transition from disease treatment to health creation with members of the World Health Organization, the Pan American Health Organization, and Health Ministers from many countries. There was an understanding that integrative medicine was going to be at the center of non-communicable disease worldwide. Integrated medicine is a much better fit for chronic disease. The goal of Evolution of Medicine is to establish more and more doctors capable of developing this new medical paradigm.

We are looking to accelerate the adaptation of the medical system to these chronic diseases, with the most effective treatments and strategies that are currently available. This is the topic of my book, The Evolution of Medicine: Join the Movement to Solve Chronic Disease and Fall Back in Love with Medicine, to be released in the fall of 2016. It is directed at modern physicians, to encourage them to heed the call to practice a type of medicine relevant for today’s epidemics.

Many systems created by medicine have been slow to adapt to this new environment such as bureaucracy, medical education, and hospitals. New evidence suggests that it takes 17 years for new clinical information to actually make its way into everyday clinical practice. This leaves us in a bit of a hole because we don’t have 17 years to wait. If we project out the increases in chronic disease over the next 17 years, we are going to see dangerous numbers for the human population with type 2 diabetes, auto-immune diseases, autism, and neurodevelopmental diseases. We need a new operating system for medicine designed for chronic disease and we need to adapt more rapidly.

What is this new operating system in medicine?

CEO and Co-Founder James Maskell with CRO and Co-Founder Gabe Hoffman speaking at the Functional Forum, New York City, December 2015
CEO and Co-Founder James Maskell with CRO and Co-Founder Gabe Hoffman speaking at the Functional Forum, New York City, December 2015

There is a grand convergence happening in medicine right now with many interested parties aiming at the same goal: reducing the cost of treating chronic disease. For the first time, people are collecting their own personal health data through wearables and genomic information. Millions of people use wearables to track their exercise, blood sugar, and sleep. The cost of genomic testing has reduced dramatically—you can now get your complete genomic profile for $100. As more medical data becomes available, people are demanding to learn how to improve their numbers, and Western medicine has no answers.

What is P4 Medicine?
Predictive, Preventive, Personalized, Participatory

Some of the most progressive medical conferences (e.g., the FutureMed Conference, put on by Singularity University in Silicon Valley) are talking about ‘P4 Medicine.’ Dr. Leroy Hood of the Institute for Systems Biology coined the term that describes how medicine must change to be more effective in the new era.

It must be predictive, preventive, personalized, and participatory.

The P4 approach contrasts with the old medical model:

  • It was not predictive. The medical system only kicked in when a health issue occurred. It did not predict disease; it reacted to it.
  • It was not personalized. The whole point of medicine until now has been defined by what the best medicine is for the average person. And there aren’t a lot of those walking the planet!
  • It was not preventive. There was very limited investment in primary or secondary prevention. The old model treats disease rather than promotes health and wellness.
  • But most important, it was not participatory. The doctor is the one who’s doing most of the work, not the patient. The doctor has t he diagnosis and the cure. So is there a medical paradigm that delivers P4 Medicine that has scalability, reproducibility, and a common language? The answer is yes, and it is called Functional Medicine.

The New Paradigm: Functional Medicine

Functional Medicine is a new paradigm that is designed around the treatment of chronic disease. It is a systems biology approach that sees the body as a whole and is based on a strong therapeutic partnership between doctor and patient. Functional Medicine has been around for about 25 years.

Question and Answer at the Functional Forum, New York City, December 2015
Question and Answer at the Functional Forum, New York City, December 2015

The Institute for Functional Medicine (IFM) was founded by Dr. Jeffrey Bland in 1991. The IFM has been on the cutting edge of delivering education, developing models, and helping this new paradigm to thrive. The IFM received significant backing in 2014 when one of the best-known functional medicine doctors, Dr. Mark Hyman, announced that the Cleveland Clinic, one of the most storied medical organizations in the world, was opening a functional medicine center. In the beginning there were just a few practitioners, but it has now grown to 18,000 square feet. In addition to having a massively oversubscribed patient base, they are conducting great outcomes research. In two years, when the Cleveland Clinic research shows that functional medicine is the most effective approach and that it lowers cost of treatment for a number of chronic diseases, my prediction is that it will be at exactly the same time when insurance companies will be looking for value-based care that is based on outcomes. We are seeing a massive uptick in the interest in functional medicine. Over a million people will search for a functional medicine doctor on the Institute for Functional Medicine’s website in 2016 and that rate is growing very quickly. Furthermore, many patients and many more doctors are realizing the benefits of functional medicine.

Where traditional medicine is doctor-centered, treatment-centered, and disease-centered, functional medicine is patient-, preventive-, and health-centered. One of the founding fathers of the functional medicine movement, Dr. Leo Galland, came up with the patient-centered diagnosis that is the center of functional medicine. Functional medicine is also based on understanding the environment—food, microbes, and the body in an ecological framework and how humans and our microbes work together to create health. This medicine is designed around the needs of chronic disease.

The major causes of chronic disease are diet, stress, lack of exercise, smoking, and lack of community and relational bonds. Many different words describe medicine that is similar to functional medicine like integrative medicine, holistic medicine, lifestyle medicine, and naturopathic medicine. Functional medicine borrows from all of those disciplines. But the reason why we back functional medicine, in particular, is that it has a reproducible framework.

At the center of the functional medicine movement is a functional medicine matrix, a common intake process that all functional medicine doctors use in order to get a complete picture of patient history and timeline, as well as antecedents, triggers, and mediators that are unique to the patient. Technologies are being developed to make the practice of functional medicine more efficient. My book alerts doctors to the possibility that a low-overhead functional medicine practice can be created in a non-traditional medical venue like co-working spaces, gyms, Crossfit boxes, and churches.

James speaking to the audience, Functional Forum, San Francisco, California, April 2016; Networking with colleagues before the Functional Forum
James speaking to the audience, Functional Forum, San Francisco, California, April 2016

In 2016, we are moving from Functional Medicine 1.0 to Functional Medicine 2.0. In 1.0, the only doctors that practiced it were ones that had found it as a way of solving either their own health crisis or a family member’s, friend’s, or a patient’s healthcare crisis that couldn’t be solved with traditional training in drugs and surgery. Now we’re starting to see more and more doctors coming to functional medicine and building successful practices around key technology assets that are being created to make it more efficient.

The elephant in the room is that to scale up functional medicine we need more doctors to do it. What I learned from speaking to thousands of doctors over the last decade is that the concepts behind functional medicine—taking time with patients, looking at their individual needs, helping to solve the root causes of their problem—are very appealing to doctors, but they don’t want to have to invest in more training. They feel they shouldn’t need more training after 10 years in medical school.

It takes a good dose of humility to admit that you don’t really have the fundamentals of health creation at your fingertips as a doctor.

Then there is also the practical aspect. There are not a lot of jobs available in functional medicine because none of the big organizations, apart from the Cleveland Clinic, are jumping on it. The only doctors today that can make it in functional medicine are doctors that have the entrepreneurial drive to build a successful practice themselves.

Networking with colleagues before the Functional Forum, New York City, December 2015
Networking with colleagues before the Functional Forum, New York City, December 2015

In Functional Medicine 2.0, systems are emerging to allow doctors to be effective in offering functional medicine and to successfully build a practice. This is a big part of what we see as the next step here: making it easy for doctors to build these functional medicine practices and to build them with a low overhead so they can start on the side in their spare time and build their practice inside a place where community actually resides.

The best results in functional medicine are being seen at the intersection of community in medicine and functional medicine. It is well positioned to take maximum advantage of that intersection. For example, Dr. Mark Hyman wrote a book titled The Daniel Plan about his partnership with the Saddleback Church and their 15,000-member congregation. They met in Bible study groups of five on Wednesday nights, in between Sunday services. By putting the principles of health creation of functional medicine together within that community setting, the population was able to lose 250,000 pounds combined—an average of 17 pounds per person—and they reduced the number of diagnoses because they had the right community support built in.

The convergence of functional medicine and community make it possible to create a sustainable movement, one that patients and doctors can get behind.

Be Part of the Movement:
Help Scale up Functional Medicine

If you are a health-conscious person you can help scale up this movement. If you really want to help spread the word about 21st century medicine, the anchor in this new medical system is full participation. You can start right now.

The four main causes of chronic disease are modifiable by the patient. An effective way to ensure your health in the long term is to cut out processed foods. Choose a diet that is mainly anti-inflammatory. Demand local or organic food. Purchase products that are organic. This will help the system to shift and also ensure your own health.

You vote every day with your dollars. Stress management and reduction techniques practiced on your own with an app or with a group play a huge part in preventing chronic disease. Exercise regularly by practicing yoga, Crossfit, or walking, and good sleep hygiene (going to bed at the right time, getting enough rest) can be really powerful for health. All these lifestyle changes are key to chronic disease prevention.

However, community is the most powerful factor in preventing chronic disease. My favorite quote from Thích Nhất Hạnh is “Community is the guru of the future.”

If you want to be part of this movement and take ownership of your health, create and stimulate a community of people in your local area that care about the same things you do. They will keep you accountable and reinforce your values. They will push you to do things when you’re losing momentum. Sustainable change happens when you take a healthy activity like walking or cooking and add the community aspect.

If you would like to be in touch, our website for the Evolution of Medicine is www.GoEvoMed.com. You can find a functional doctor here or if you are a traditional doctor, you will find helpful resources. You can have a free concierge call with a member of our team and view episodes of our show. We encourage you to become a leader in your community by introducing these concepts to your local doctors and building a community of healthy people.

You can build a Functional Forum Meetup Group. We now have over 200 meetup groups of physicians worldwide that get together regularly. Get help to start a meetup group. It’s free at www.Meetup.FunctionalForum.com. One of the first communities that you can easily help build is one of allied health professionals that believe in this new model. They are everywhere and they don’t always have an MD after their name. Creating that community will create a local safe space for doctors to feel welcome. Different types of people are very successful at creating these meetups. I created this whole structure myself and I have no medical training. I am just passionate about helping solve chronic disease. Anyone can make an impact on healing and health with new paradigm approaches. We have created the resources and an ecosystem to do it.

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