Note to Self: “Functional Medicine” Is Still Bullshit

There is always going to be some percentage of doctors who have lost the plot.

Image credit: ovariancancer1 from Pixabay

It’s been a few years since I last wrote about Functional Medicine at Skeptoid, but it reared its ugly head again the other day when I was at the dentist. Another patient was at the front desk asking — nay, demanding — some Functional Medicine version of dentistry. The poor front desk clerk had no idea what this person was talking about. I did. I had to roll my eyes and bite my tongue — which was easy since half my face was dead with Novocaine.

Functional Medicine (FM) is an alternative medicine system that employs fear-based marketing to scare you away from medical doctors. These are their basic claims, and you’ve heard these all before as they’re ubiquitous in alternative medicine:

• Mainstream doctors only treat symptoms, they don’t try to find or treat the underlying cause;

• Mainstream doctors see you as a disease, instead of as a complete n complex human being;

• And once they pigeonhole you as a disease, they know and follow only a single one-size-fits-all course of treatment that does not take into consideration anything else about you.

Of course, as any “mainstream doctor” will tell you, these tired old claims are all absolutely, 100% false. Doctors work in the opposite way of that description.

Here is the Cleveland Clinic’s¹ description of their FM department:

Our functional medicine model of care takes a patient-centered approach to chronic disease management. It seeks to answer the question, “Why are you ill?” — so you can receive personalized, effective care recommendations.

Our functional medicine providers listen to you, gather your medical history and connect to your context of living. We use this information to identify underlying reasons behind your condition — including predisposing factors like genetics, and things that keep us feeling poorly, including poor nutrition, stress, exposure to toxins and harmful substances, allergens and impaired gut health.

Based on this evaluation, we assess your readiness and ability to make changes while customizing a healthy living plan. Your plan will address modifiable aspects of your life, including nutrition, exercise and sleep. It will also focus on your mental and emotional health.

In other words, THEY DO EXACTLY WHAT EVERY DOCTOR ON THE PLANET IS TRAINED TO DO. They’ve shrewdly changed the plot to appeal to your fears about doctors, deceptively affirmed your fears to give you a psychological boost, and then they offer you the same medical treatment with a BS brand name stuck on it.

Well, that’s not quite true. They do trowel on a generous layer of bullshit so that you actually do receive something extra. It’s usually a regimen of expensive supplements that are unlikely to do you either any harm or any good, but they appeal to your sense of having conquered a corrupt system and found a real doctor who cares.

In the Cleveland Clinic’s own description above, they’ve also thrown in some pop-culture buzzwords that the average innocent patient has heard about on Facebook and is scared of, like toxins and poor gut health. Luckily, these supplements will clean those right up!

In my experience, FM doctors come in two varieties:

1. Doctors who were probably never very good doctors, and/or became disillusioned with their profession somehow, and adopted a “malcontent” position against mainstream medicine that appealed to their acquired distrust of it;

2. Doctors who are savvy businesspeople, and recognize that every flavor of SCAM (Supplementary, Complementary, and Alternative Medicine) has market demand from consumers who have heard about it and want it. So, fine; if patients are willing to pay extra for some bullshit supplements, take their money. They still understand real medicine, they’re just willing to pander to patients’ misguided fears and desires so long as it won’t do them any real harm.

In my mind, the mixture of real medicine with bullshit is an even greater threat to public understanding of science than is just bullshit alone. Joe Rogan is a great example of this. He sometimes has on real scientists or innovators or businesspeople, but mixing them in indiscriminately with his usual crowd of anti-science crackpots and weirdos leads to people not being able to tell the difference. “Oh, he had on this really cool physicist last week, this person must be good too.”

The FM equivalent is “Oh, my awesome doctor who’s keeping me alive with insulin is also selling me a customized prescription of herbal supplements, so they must be good too.”

Bullshit is bullshit — even when it’s just a thin disguise of better bedside manner.

1. The country’s largest purveyor of bullshit alternative medicine. But they offer conventional medical treatment too, contributing to the problem of conflation that I described.