A few things seem to be true of most patients who end up in a DC’s office:
- They want a good result paying much or having to drastically change their lifestyles.
- They are disease- or symptom-oriented. Whatever the problem, they are likely to expect a single fix. Seldom is there a single fix.
- Many will think of you as just being able to fix kinks and strains.
- Almost everyone thinks he or she eats “a pretty good diet.”
First principles of a functional medicine practice
The first and most important thing to teach patients is that you are fixing infrastructure. You are getting the body healthy enough to stop having symptoms.
Emanuel Cheraskin created a great model for explaining how natural healthcare works. It is contained in this chart, which can be printed on 11-by-17-inch paper: If you have trouble printing it, email me at paulgvarnas@gmail.com and I will send you a copy you can take to a printer. You definitely need a printed copy.
Now, go over Cheraskin’s chart with every patient. Most need to begin to think differently about health and sickness. You also need to begin to think this way, realizing that in functional medicine you are not treating disease (and a lot of DCs don’t grasp this).
For example, you may give a patient with asthma some magnesium. More often than not, their symptoms will improve. The magnesium did not treat the asthma; it treated a magnesium deficiency. It just so happens that an asthmatic who is deficient in magnesium is likely to have worse asthma symptoms than an asthmatic who is not deficient in magnesium. You did not treat asthma; you fixed a little portion of the infrastructure and were rewarded with improvement.
Use metaphors like peeling the onion or like taking straws off the camel’s back. Your functional medicine patients need to understand that this is a different kind of healthcare and they need to play an active role in it.
Diet
My book, The Roadmap to Health, is a good starting point for the dietary changes you will want to recommend to patients. It may need to be tweaked for some, but most of them will improve by following the diet. It does not address lectins, and some of your patients may have food sensitivities, so you may need to adjust the diet to the patients’ needs. The good news is that the vast majority of patients improve when following this diet, because:
- It is an anti-inflammatory diet. Refined foods, chemical additives, processed and hydrogenated oils and heavily sprayed foods all create inflammation. Fresh fruits, vegetables, nuts and seeds all fight inflammation.
- It helps improve the microbiome. Good bacteria are supported by vegetable fiber, and this diet is very high in vegetable fiber. It also adds the discipline of the Specific Carbohydrate Diet, which is used to treat Crohn’s disease, irritable bowel syndrome, ulcerative colitis, small intestinal bacterial overgrowth and gastroesophageal reflux disease. Patients’ digestion will improve.
- It avoids many common “allergens” (actually, foods to which many individuals are sensitive). There are no complex carbohydrates, so there is no corn, wheat (gluten), dairy or soy allowed.
- To improve digestion, patients are encouraged to chew food until it is liquid before swallowing it.
The PDF version of the book has recipes and menu plans. If you want a hard copy instead of the PDF, email me at paulgvarnas@gmail.com.
The vast majority of patients will improve while following the diet outlined in Roadmap to Health, but it is not perfect for everyone. The issue of lectins, a big deal for some (not many), is not addressed. Some people will have other food sensitivities, like eggs or nightshades. For others, the diet is stricter than it needs to be. For most people, it is a great start for their functional medicine journey.
Anyone can do anything for 30 days
Ask patients to follow a diet for 30 days. When it comes to processed foods, you will find many of them are addicts. The food industry hires neuroscientists to help them fine-tune the formulas of processed foods. They use PET scans to see if they are stimulating pleasure centers with the food. (Read Michael Moss’s books about the food industry for more information.)
If patients can stick with the diet for a month, that’s long enough to demonstrate what a difference good nutrition can make in their health and in how they feel.
Final thoughts: Stay positive
Get comfortable with the idea that your patients may not stick to their plan, at least at first, and some will progress faster than others. Encourage them to do better, and avoid criticizing them when they fall short.
Also, avoid creating learned helplessness. Many natural healthcare practitioners like to talk in detail about everything that is wrong with the food supply. Often, this leaves patients feeling that any effort is pointless and that “everything is bad for you.”
Remain calm and focused, and keep working with patients to make improvements.
Coming up in part three of this article series, we’ll delve into a few simple functional medicine approaches to pain relief, which should always be a priority.
PAUL VARNAS, DC, DACBN, is a graduate of the National College of Chiropractic and has had a functional medicine practice for 34 years. He is the author of several books and has taught nutrition at the National University of Health Sciences. For a free PDF of “Instantly Have a Functional Medicine Practice,” a copy of the Cheraskin chart mentioned in this article, a pdf copy of his book Roadmap to Health or a patient handout on the anti-inflammatory diet, email him at paulgvarnas@gmail.com.