Palmoplantar Psoriasis: Causes, Symptoms, Risks, Treatment
What Is A Functional Medicine Doctor?
Functional medicine doctors use specialized training and techniques to find the root causes of chronic illnesses. They work holistically, considering the full picture of your physical, mental, emotional, and sometimes even your spiritual health. They provide "patient-centered" care, which means they spend time learning about you, your lifestyle, your medical history, family history, and your needs in order to find a solution to your heath problems that's personalized to you.
Are functional medicine doctors MDs?
There are a wide variety of functional medicine "practitioners," but not all of them are Doctors of Medicine, or MDs. Physicians assistants and chiropractors might practice functional medicine, for example, but they haven't gone to medical school to earn an MD degree.
A Doctor of Osteopathic Medicine, or DO, is another type of medical professional that might practice functional medicine and be referred to as a functional medicine "doctor." Like MDs, DOs have similar education and credentials to practice medicine. They have done residencies, can prescribe medication, and they are licensed to practice medicine in their state. They may also become board-certified like doctors.
Both MDs and DOs – as well as functional medicine practitioners who aren't medical doctors – who practice functional medicine may take additional courses specific to functional medicine. The American Association of Family Physicians has accredited some, but not all, functional medicine courses.
Because the field of functional medicine isn't standardized like traditional medicine, it's important to do your research when choosing a doctor. Some functional medicine practitioners who aren't medical doctors may provide treatment for chronic illness, but these methods often have little scientific evidence to support them. In some cases, they could also be dangerous for you. If you decide to go to a functional medicine doctor for treatment, make sure they have MD or DO credentials and are licensed to practice medicine in your state.
Functional medicine doctors look at your full history to identify the root causes of an illness. They collect detailed information about the disease and your overall lifestyle. Functional medicine doctors often spend more time with their patients in order to get all the information they need.
A functional medicine doctor may ask you about:
Then, they come up with a treatment plan to manage the many factors that may be contributing to your chronic condition. Unlike traditional doctors, who might prescribe prescription medicine or surgical procedures as the main treatment, functional medicine doctors often first look to improve things like diet, exercise, sleep, and stress reduction. Of course, if there is an immediate medical need, your functional medicine doctor can also prescribe medication and recommend conventional medical procedures.
Finally, your functional medicine doctor will track your progress and make changes as needed. The approach is different for each person, since functional medicine is centered around personalized treatment plans.
Your relationship with your functional medicine doctor may also be different than with your primary care doctor. Functional medicine tends to be a more collaborative partnership between you and your doctor. Your doctor considers your input while still keeping you responsible for your choices as they relate to your condition and treatment.
Functional medicine vs. Integrative medicine
Functional medicine and integrative medicine are very similar. For example, both use diet and nutrition as primary tools for fighting chronic illness and take a holistic, individualized approach to your health. Both are also often considered "alternative medicine" by the mainstream medical community.
But there are a few key differences between the two. Functional medicine still relies on tools such as blood tests, allergy tests, and genetic testing. With integrative medicine you're less likely to have those tests; instead, your health care provider focuses on the mind-body aspects of health. Integrative medicine doctors are more likely to recommend noninvasive treatments for you and are less likely to prescribe "non-natural" medications.
Functional medicine is based on the idea that every patient is unique and that many factors such as family history, lifestyle, and environment interact with each other. For example, if you are diagnosed with heart disease, this could be due to a combination of genetics, diet, stress, and other lifestyle factors. Your treatment plan would take all of these into consideration to get to the root cause of your disease.
Rather than just treating your heart disease with medication or surgery, your treatment plan would also try to treat the things that are causing your heart disease. That could be changing your diet, getting more exercise, and reducing your stress levels. While some mainstream doctors also incorporate these elements into their treatment plans, it is not as common. In functional medicine, this is central to your treatment.
To be a functional medicine doctor (MD or DO), you have to go through traditional medical school training. You can then choose to get additional certification from an organization such as The Institute for Functional Medicine. Then you can apply functional medicine teachings to your medical field of practice.
Additional certification does not give you any further legal status, but it shows that you have trained and are committed to working within this field of medicine.
Functional medicine doctors can treat a variety of health issues. They normally focus on chronic conditions that affect physical and mental health, such as:
If you do not have a chronic illness, you can still visit a functional medicine doctor. Many also focus on preventative care.
Seeing a functional medicine doctor might be right for you if:
You want a more personalized type of health care. Functional medicine doctors typically spend more time with you and more time assessing all the factors that affect your health. Functional medicine addresses each person individually. Using different methods than a conventional medical doctor, a functional medicine doctor will help you figure out which specific treatments are right for you.
You're interested in how things like genetics, mental health and lifestyle habits contribute to your illness. Your treatment will address all of these things individually, which will improve your whole health.
Your chronic illness hasn't responded well to traditional treatment. You might continue to receive conventional treatment, but functional medicine can open up other options that could be better than or work well with your existing treatment plan.
Functional medicine is not as widely practiced as regular medicine, and there are fewer functional medicine doctors to choose from. If you live far from a major city, it can be more difficult to find one.
A good place to start is with the The Institute for Functional Medicine's online provider search tool. You can put in your ZIP code and see which doctors are closest to you. You can also read reviews from patients that can help you decide whether the doctor is right for you.
Functional medicine seeks to treat patients holistically and individually. Many people find it to be a helpful approach to treating chronic conditions that conventional medicine hasn't been able to treat. But some of the foundational principles of functional medicine are not yet scientifically proven, and there is less standardization in the quality of care you might receive. For these reasons, you may wish to proceed cautiously when seeking functional medical care.
What does a functional medicine doctor do?
Functional medicine doctors use a more holistic approach to treat chronic conditions. This includes taking your lifestyle, genetics, mental health, and environment into account when making a treatment plan.
Are functional medicine doctors legitimate?
Functional medicine doctors need to go through conventional medical school training. They can then choose to practice functional medicine. Since the standards aren't as well established in the functional medicine field, people may pass themselves off as doctors without having the necessary credentials. It's important to do your research and check that your functional medicine doctor has legitimate education and licensure.
Functional medicine itself is sometimes questioned for its legitimacy. There isn't as much scientific research to prove that the methods it uses are effective. That's why many people prefer to stick to conventional medicine. In the future, there may be more studies that prove the effectiveness of functional medicine.
Of course, just because an approach hasn't been verified yet through rigorous research doesn't mean it's junk – but it does mean that you should be cautious if you decide to proceed with a functional medicine professional. Ask for their credentials and seek other treatment options if their suggestions raise any red flags.
Is a functional doctor the same as a holistic doctor?
While there is some overlap between a functional medicine doctor and a holistic doctor, there are also a couple of important differences. Both types of professionals try to treat patients by taking a multifaceted, individualized approach. However, holistic doctors typically avoid prescribing conventional medications or recommending surgery. Functional medicine doctors may be more open to these options.
Where Did My Doctor Go? Orlando Health Won't Tell Me
When Orlando Health told Andrew Gasparovic his cardiologist was leaving, he asked where the doctor was going.
Staff would tell him only that his doctor was departing Oct. 1, and that he could switch to a new doctor within the system or take his medical records and transfer to a doctor outside the system.
Gasparovic said he talked to multiple Orlando Health employees, seeking context. Did his doctor retire? Did he die? Did he move to another state? Did he leave contact information? Gasparovic, 88, says the answers he received were inconsistent. Finally, an Orlando Health staff member told him over the phone they were instructed to say they didn't know, he said.
As it turns out, Gasparovic's doctor was working right down the street from Orlando Health's main cardiology office and still had medical privileges at Orlando Health hospitals. He was one of 27 cardiologists previously employed by Orlando Health Heart and Vascular Institute who in October left to form the Cardiovascular Center of Florida. The new practice was established by Cardiovascular Associates of America, which was formed by private equity firm Webster Equity Partners.
This mass exodus of doctors has spawned multiple lawsuits, angered patients and ignited an ethical debate about what hospitals and doctors are obligated to do when a doctor leaves a health system. Everyone agrees the transition could have gone more smoothly for patients, but they disagree on who is at fault, what could have been done differently and what the best outcome for patients looks like.
The cardiologists who left say they met and possibly exceeded the industry standard for communicating their plans, giving several months' notice and providing Orlando Health with their new contact information and office locations. They estimate they have about 50,000 active patients between them. Orlando Health sent a letter to these patients informing them their doctor was gone but not where they went.
But Gasparovic said that Orlando Health's messaging initially gave him the false impression that his only option was to choose a new doctor. For patients determined to stay with their doctor, denying them information wastes time and causes stress, he said.
"The patient-doctor relationship is sacred. You have no right to deny me my doctor," Gasparovic said.
'That's not our job'It's long been industry practice for medical groups, private practice groups and health care systems not to give patients their old doctor's new information upon their departure, or say why the physician left.
"That's just the way it's done universally, throughout the United States," said Dr. Jamal Hakim, chief physician officer of Orlando Health. "That's not our job."
Information and location of the doctors who left Orlando Health for the Cardiovascular Center of Florida can be found by going to cardiovascularcenter.Com.
"There is no physician in the United States that you can't open a computer, Google their name and find out where they're practicing," added Dr. Aurelio Duran, a cardiologist who chose to stay with the Orlando Health Heart and Vascular Institute.
Rick Harrington, 55, of Tavares, said he was told by Orlando Health staff that his doctor retired. "If you don't know he is still a doctor and not retired, why would you Google him?" he said via text. Harrington said he spent several hours on the phone and in person sorting out where his doctor was with Orlando Health staff before finding out he had moved to the new Cardiovascular Center of Florida practice.
Orlando Health's Hakim contends it's easier for patients to stay within a large health system that already has all their records than to leave with their doctor.
"Ethically, the best thing for an elderly patient who may not be able to navigate well is just staying in the health system. So, we're trying to follow our moral compass here," Hakim said.
But Dr. Adam Waldman, one of the cardiologists who joined the new Cardiovascular Center of Florida practice, said he has talked to patients who wanted to keep seeing him but struggled to figure out how. Patients are better served staying with a doctor who knows them personally, he argues.
"There's a ton of patients who are upset, stressed and unduly put through this process," Waldman said. "It's really sad, and it's really disheartening."
Dr. Adam Waldman at the new Cardiovascular Center of Florida, located near the Orlando Health campus, Thursday, Nov. 30, 2023. 27 cardiologists at Orlando Health —with approximately 50,000 active patients between them— left the hospital and started the practice, currently with 8 locations across Central Florida. (Joe Burbank/Orlando Sentinel) That's an issue the departing cardiologists could have helped handle, say some of the 51 doctors who stayed at Orlando Health.
Orlando Health Heart & Vascular Institute's Dr. Muhammad S. Ghumman said it was the responsibility of the doctors who left to make sure their patients were taken care of.
"[The doctors] could have looked ahead and [thought], 'I have patients scheduled for procedures; these are the phone numbers. I should take care of this before I leave, knowing there might be a gap of a month or two months, or however long until the services can be provided,'" Ghumman said.
The physicians who stayed behind have expanded their clinics and hours to take on the patients of those who left. And the Orlando Health system has hired 18 new cardiologists as of Wednesday to close the gap and intends to hire more, said Andy Shunk, assistant vice president at Orlando Health.
Shunk offered assurance that despite the confusion, patient wait times for new appointments are the same now as they were before the physicians' departure.
Ghumman said that since the doctors departed, he has seen hundreds of their patients. He said he hasn't heard any complaints.
"Not a single one of them is coming to my office, meeting me for the first time and saying 'I'm only here because I couldn't find out where my cardiologist went, and I didn't have a choice,'" Ghumman said.
He, like many cardiologists at Orlando Health, was also approached to join the new practice but declined.
He shared concerns that the new practice is owned by a private equity firm, which he said could imperil patient health.
This is a debate that will remain relevant in the future as private equity groups continue to buy up the health care sector, a trend that has accelerated over the past decade, according to a 2023 analysis published in BMJ, which also found that private equity was often associated with increased costs for patients.
Enter the lawsuitsOrlando Health and the Cardiovascular Associates of America are currently embroiled in a civil lawsuit in Orange County Circuit Court related to the 27 physicians who left, the hospital's response, and the impact it has had on both of their businesses.
In June, Orlando Health and Orlando Health Medical Group filed a claim against Cardiovascular Associates of America, its CEO Cardiovascular Institute of Central Florida and several of the companies owned by Cardiovascular Associates of America.
Orlando Health alleges, among other things, that the group encouraged some of the physicians who left to breach employment contracts and share trade secret data, and that the establishment of this new practice is unfair business competition under Florida law.
The Cardiovascular Institute of Central Florida denied these allegations and filed a counterclaim in late October alleging Orlando Health engaged in deceptive trade practices by not telling patients the whereabouts of their physician.
Ccatherman@orlandosentinel.Com; @CECatherman Twitter
How To Find The Best Gutter Installation Near Me In 2023
Gutter installation is a crucial part of home maintenance, and it can be one of the best investments you can make to protect your property from water damage. The cost to install gutters can vary significantly depending on several factors, including materials used, complexity of installation, labor costs and more. Here are some general guidelines to give you an idea of what you might expect:
MaterialsThere are a few different types of gutter materials, and the type you choose will significantly impact the cost. Common materials include vinyl, aluminum, steel, copper and zinc. Copper gutters are generally more expensive than other materials.
As a general rule, the cost of guttering installation will increase as the size of your home increases. With more linear feet of guttering to install, you'll naturally be looking at a higher overall price. The number of stories in your home can also affect the cost slightly, as it may require special equipment or additional labor for taller structures.
Gutter StyleWhen considering the cost of your gutter system, it's important to consider the different options. You can choose between various types, such as K-style and half-round gutters. Each will have different costs, so consider these options before deciding what type of gutter you want installed on your home.
Labor costs for gutter installation can vary based on your location and the complexity of the installation. If your home requires special considerations, such as a steep roof or difficult access, it may increase the labor costs. Labor costs also depend on how long it takes to complete the job. If you have an older home with outdated gutters, it could take longer than installing new gutters on a newer home.
Geographic LocationWhen you're looking for an expert to install your gutters, it's important to be aware of your area's cost of living and business expenses. Geographic location plays a pivotal role in shaping the economic landscape, with certain areas experiencing higher costs for labor, materials and operational overhead. If you live in an area where the cost of living is generally higher, you may find that gutter installation expenses reflect these economic factors.
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