I&FM Criticism

The medical establishment can be negative towards integrative and functional medicine (“I&FM”). This has been the case with any potentially competing health care approach. Before chiropractic licensure was implemented, chiropractors could be jailed for practicing medicine without a license. Even after chiropractic licensure was approved, the American Medical Association referred to chiropractors as “rabid dogs” and sought to eliminate chiropractic services. Over time the medical establishment has come to be more accepting of chiropractors, with allopathic physicians and chiropractors working together in multidisciplinary groups.

I&FM presents another “turf war” for the medical establishment, as I&FM provides patients an alternative to always receiving traditional care. Most traditional providers would probably prefer not to have this competition. Some established entities are embracing I&FM, (such as the Cleveland Clinic), but many in the medical establishment would be happier with the elimination of I&FM from a purely business perspective.

The medicine establishment has also been negative about complementary and alternative medicine (“CAMs”). Traditional medicine has only come around to embracing meditation, nutrition and other aspects of integrative medicine, because the evidence for its effectiveness has become overwhelming. Much of this evidence wouldn’t exist if traditional medicine had its way to dismiss these approaches from the beginning.

Even some diagnoses have been discounted until “alternative” providers prevailed in having them widely recognized. The Center for Disease Control (“CDC”), for example, historically only recognized acute Lyme disease. In 2013, the CDC adjusted the number of Lyme disease cases in the United States from 30,000 to more than 300,000 and acknowledged that Lyme disease can be chronic (click HERE).

The medical establishment also has a history of dismissing its “failures” while judging other approaches only by its “failures.” Consider the “number needed to treat” or “NNT.” Traditional medicine is perfectly happy to prescribe medication for a percentage of the population that receive no benefit. This concept is the number needed to treat, which is the number of patients who statistically need to take the medication before ONE patient receives the desired benefit, (explained much better HERE). For statins, the NNT over five years is 60 for a heart attack and 268 for a stroke, (explained much better HERE). That means that 59 patients taking statins receive no benefit in heart attack prevention, while 267 patients taking statins receive no benefit in stroke prevention.

Does traditional medicine say that it has “failed” or “deceived” the 267 patients who take a statin for stroke prevention but receive no benefit? No. Traditional medicine’s position is that this NNT is acceptable. Who made the calculation that treating 268 patients to prevent ONE stroke is acceptable? Traditional medicine. The medical establishment, however, loves to point out patients who receive no benefit from CAMs as failures, even if other patients do benefit from those same CAMs.

And the NNT doesn’t even take into account the “acceptable” side effects to medication. Read the fine print on all of the biologics currently being advertised. The extended life they offer is often mere months at a risk of a litany of side effects–including death–and most patients who take them will receive no benefit. It is necessary to implement the medication if those extended months are to become years, but the medical establishment should be as realistic about traditional medicine as they should be about functional medicine.

Just like traditional medicine, I&FM can be filled with potholes. Are some I&FM providers going to seem to be all about the money? Sure they are—just like some traditional providers. Are there lay people, health coaches and chiropractors pushing the envelop on services that may be beyond the scope of what they should be doing? Yep—just like traditional medicine. Is I&FM going to help every patient? Nope—just like traditional medicine.

Most importantly, many I&FM providers find that their patients come to them only after traditional medicine has failed to help their issues. Before the medical establishment dismisses I&FM, the question needs to be answered why these patients feel so abandoned by traditional medicine. If traditional medicine could help these patients, there would be no demand for I&FM. 

Patients interested in I&FM to look for a “full spectrum” I&FM physician. Some focus only on one condition or one treatment, (like fatigue or IV infusion). E3fm.com has a state by state list, (click HERE), and other information. It is a good place to start.