Writing in the Deseret News, Jody Berger explains why the Cleveland Clinic has enlisted a "functional medicine" doctor whose goal is to "cut the number of angioplasties and bypasses in half and reduce hospital admissions."
Why Cleveland Clinic is pursing functional medicine
Functional medicine uses holistic treatments to identify and resolve the root cause of chronic diseases, which accounted for $2.16 trillion of the $2.7 trillion spent on U.S. health care in 2011.
Functional medicine is "a systems approach to biology," according to Jeffrey Bland, founder of The Institute for Functional Medicine. It is "different from the model that says, 'here's a pill for every ill.'" Currently, most physicians focus on managing the symptoms of these patients; functional medicine doctors try to cure the problem.
According to Bland, origins of non-communicable diseases are found in the relationship between a person's genetic disposition, environment, and lifestyle. Genes may put people at risk for certain conditions, and their choices push them toward some. Functional medicine works to distance patients from those risks by encouraging healthy decisions.
"We're going to witness an unbelievable shift around non-communicable diseases" in the near future, he argues.
In his book, Cleveland Clinic CEO Toby Cosgrove wrote that chronic ailments "are now so prevalent and so costly that they're threatening to destroy America's broader economic health." The 74-year-old cardiac surgeon says, "We must consider new approaches to understanding and treating diseases."
Twenty-two months ago, Cosgrove met with Mark Hyman—a functional medicine doctor and the chair of The Institute for Functional Medicine—to explore creating a functional medicine department at the renowned hospital. Hyman told him: "If I create a program there, it would cut the number of angioplasties and bypasses in half, and reduce hospital admissions."
Or more plainly, Hyman said, "Hire me and I'll do what I can to put you out of business."
The Clinic's new functional medicine center
On Sept. 23, Cleveland Clinic opened its Center for Functional Medicine, with Hyman as its leader. The move makes it the first large organization to offer the functional medicine model, according to the Cleveland Plain Dealer.
The center has a staff of just four doctors, a health coach, and a nutritionist.
When patients arrive, they complete a detailed questionnaire that is reviewed by their doctor before they meet. Physician-patient sessions last between an hour and 90 minutes and are followed by a 45-minute meeting with a nutritionist. The team then collaborates with a health coach to create a care plan filled with healthful foods, exercise, and sleep.
"We want to create (better) function in a body by restoring balance," Hyman says, arguing that doing so can help symptoms fade and make medication unnecessary.
For example, instead of prescribing cream to relieve the red, itchy symptoms of psoriasis, the health team may suggest a different diet to resolve the issue at its source.
Physicians across the Cleveland Clinic are already asking to collaborate with the new staff, and patients from across the country and Canada have called asking to make center appointments (Berger, Deseret News, 11/2; Townsend, Cleveland Plain Dealer, 9/22).
We're approaching the end of the generalist PCP model
Chas Roades, Chief Research Officer
One critical outcome of designing the clinical workforce for three distinct clinical products is the end of the traditional primary care practice model.
The industry is moving toward a more customized, consumer-centric version of primary care access, and the standard one-size-fits-all PCP office model just won't suffice. Neither will the first iteration of the medical home, which makes only incremental improvements on the baseline PCP office model.
There isn't a single primary care model that meets all the needs of the future. Instead, many organizations will deploy a tiered primary care model, with each level designed to meet the demands of a different segment of the patient population.