Aunna Herbst, DO, was in her early 30s when she decided to go to medical school. The former lifestyle and health coach had gotten into nutrition for personal reasons. But when her business became so successful that it grew too big, she decided to sell it.
Her love of biochemistry coupled with her natural affinity for healing led her to Oklahoma State University College of Osteopathic Medicine (OSU-COM).
“During residency training, I wondered how I was going to incorporate the two worlds of osteopathic medicine and nutrition,” says Dr. Herbst. “I pursued functional medicine as a means to bridge them.”
Dr. Herbst’s functional medicine pursuit was very successful and led to a gig helping the Cleveland Clinic get their fledgling Center for Functional Medicine started. Many of the holistic qualities of functional medicine align with those of osteopathic medicine, she notes.
What exactly is functional medicine?
If you’ve wondered about the specifics of functional medicine, you’re not alone.
According to the Institute for Functional Medicine (IFM), which is considered the gold standard of training in the field, “the functional medicine model is an individualized, patient-centered, science-based approach that empowers patients and practitioners to work together to address the underlying causes of disease and promote optimal wellness.”
Functional medicine practitioners incorporate modalities such as nutrigenomics, which looks at an individual’s interaction between nutrients and their genes, pathophysiology and biochemistry to optimize function, says Dr. Herbst.
“Functional medicine is what A.T. Still must have envisioned osteopathic medicine to be,” she says. “It’s a truly holistic approach.”
After training at IFM, Dr. Herbst set up practice in Grove, Oklahoma, and “natural medicine seekers began coming out of the closet” as her practice grew exponentially.
She became so well-regarded in the field that when the Cleveland Clinic decided to delve into the world of functional medicine, they invited Dr. Herbst to join them. Dr. Herbst helped the Cleveland Clinic develop and expand the Cleveland Clinic’s Center for Functional Medicine (CCCFM). She became the center’s second full-time physician in 2015 before becoming its operations director for a year. She has recently returned to private practice back home in Oklahoma.
For Christine Maren, DO, functional medicine filled a void, both professionally and personally. Growing up in Boulder, Colorado, she had what she describes as a “holistically minded upbringing,” which is why she gravitated toward osteopathic medical school.
When she wasn’t getting answers to her own health problems through a conventional medical model, she went down the path of functional medicine as a patient first before becoming a practitioner.
“Functional medicine is a very individualized and personalized approach to medicine with a focus on root cause rather than symptomology,” says Dr. Maren. “I always think it should be called ‘root cause medicine.’ ”
FM takes time, engagement
While conventional medicine does a great job at treating acute and emergency medical situations, functional medicine is better suited toward chronic illness, says Dr. Maren.
“Most of my patients have seen conventional doctors and didn’t get effective treatment. They need someone to dig deeper and do a lot of investigative work,” she says.
At CCCFM, Dr. Herbst estimates that over 60 percent of the patients had a chronic illness and had exhausted all other treatment options. “They’d often come in with reams of medical records. They’d been to the likes of a Mayo Clinic and nobody could help them.”
Athletes, often professional, comprise another large group of patients at CCCFM, led there by a desire to optimize their health and prevent disease. “Mom and dad have dementia, and I don’t want it,” is typical of that group, says Dr. Herbst.
A third group of patients were not sure why they came there and were hoping for a quick fix. “Functional medicine is not a quick fix,” says Dr. Herbst. “It’s a process. It takes work and an active patient, or it won’t be successful.”
The rise of FM
Functional medicine is still a relatively fledgling field that is beginning to see explosive growth. The CCCFM, which opened in 2014, quickly outgrew its space and has since expanded into a prime 10,000-square-foot facility with more satellite locations being added, says Dr. Herbst.
Despite its popularity, functional medicine is often criticized for its use of clinical evidence rather than research-based evidence.
“At first, the Center was considered the two-headed stepchild for specialists at Cleveland Clinic,” says Dr. Herbst. “But the more grand rounds we made and the more progress we made with patients, the more they came around.”
A series of studies which include functional medicine approaches to asthma treatment, Type 2 diabetes and prostate cancer are currently underway at CCCFM.
“Our goal at CCCFM was to put functional medicine’s name out there,” says Dr. Herbst. “And really the only way to do that is through studies.”
A new model
Part of the allure of functional medicine, and why academic hospital-based centers like Cleveland Clinic are embracing it, is motivated in part by the shift in medical reimbursements toward outcomes instead of volume, according to an interview in Holistic Primary Care with Mark Hyman, MD, who along with Patrick Hanaway, MD, was instrumental in starting Cleveland Clinic’s CFM.
A report on outcomes of more than 4,200 patients treated at CCCFM found that CCCFM patients had greater clinical improvements and lower health care costs than patients receiving conventional care at Cleveland Clinic.
Part of the success of functional medicine is grounded in what might be considered an osteopathic approach to care: partnering with your patient and believing in the body’s innate ability to heal.
“What I loved about my DO training is the underlying philosophy that the body has an ability to heal itself,” says Dr. Maren.
In functional medicine, Dr. Maren says, “I found an entire tribe of people who were asking the same questions I was asking, which is why. And functional medicine helps me find answers to that for myself and also for my patients.”