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Results from a Functional Model of Care

By October 31, 2019Commentary

I am always willing to learn about new approaches to care management.  Research in the Journal of the American Medical Association Network Open looks at use of something called the Functional Medicine model of care.   (JAMA Open Article)    According to the article, functional medicine “provides an operating system that works to reverse illness, promote health and optimize function by addressing underlying causes, symptoms, and functional imbalances in interconnected biological networks.”  Uhhh, okay.  Social determinants (of course) and use of food as a medicine are apparently also key.  Anyway, the researchers used a retrospective cohort study conducted at a Cleveland Clinic primary care site.  Patient-reported data was used to calculate a health-related quality of life score.  Patients who received more traditional primary care were compared with those who were treated at a Functional Medicine Center in the clinic. The Functional Medicine patients were required to see a dietician and a health coach.   There were about 400 matched patients in each arm of the study.  At six months the patients treated at the Functional Medicine Center had statistically significant better improvement in their self-reported health status scores, but this difference did not remain statistically significant at 12 months.  The study is pretty useless, or at least the writeup is, it tells us nothing about what was actually different in the treatment of these patients and it makes no attempt to identify which aspects of the difference in treatment might have been responsible for the initial improvement in scores.  In addition, it is hard to understand why you are relying solely on patient-reported data when all kinds of biometric and other information must have been readily available.  This may be a beneficial approach to treating patients, especially those with chronic, lifestyle related diseases like diabetes, hypertension and arteriosclerosis, but I am not sure this kind of study really tells us anything meaningful about Functional Medicine’s utility.

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