In Wednesday’s podcast, we had a great conversation with Rob Abbott about common practices in functional medicine and how to improve the patient experience. Whether you’re a practitioner or a patient in search of a practitioner, this information can benefit you.

If you need help getting started with functional medicine, click here

Practical Tips for Practitioners to Improve Your Patient Experience

In Wednesday’s podcast, we had a great conversation with Rob Abbott about common practices in functional medicine and how to improve the patient experience. Rob is currently in traditional medical school while also studying functional medicine. After spending a day at our clinic, he offered some great insight that we wanted to share. Whether you’re a practitioner or a patient in search of a practitioner, this information can benefit you.

Currently in functional medicine training, they emphasize patient storytelling. The model is that in the initial appointment, the patient will share everything that’s going on with them and go through their history of when symptoms started. This consultation is usually designed to be 1.5-2 hours.

The concept of this approach is good. People want to be heard; they want to get stuff out. Some level of therapeutic storytelling can be very helpful to let patients say all the things they want to say. But at the same time, it’s important to stay focused on the main issue in order to create a treatment plan that works.

As a practitioner you could have an initial patient consult that lasts 2 hours and you can get really detailed about every health concern they have. However, that isn’t usually necessary, and it makes it really expensive for the patient. The goal of a practitioner should be to provide the most targeted and effective treatment at the least expense to the patient.

A better method is to have well-designed intake paperwork and review it prior to the patient appointment. If your paperwork is good, you’ll be able to see the key areas you need to hone in on. That way you can allow your patient to tell their story, but you guide them to the areas that need the most focus.

Just as more testing doesn’t equal better results, the same is true with the patient conversation. More question asking doesn’t necessarily lead to better results, unless those questions are targeted to the main issues.

How to treat?

Functional medicine generally tries to tackle all body systems at the same time, and this can be extremely overwhelming and not always effective. A better approach might be to prioritize body systems based on the patient. An example would be to target nutrition and gut health first rather than trying to do everything at once.

It’s important to meet the patient where they’re at, otherwise you might overwhelm them and they don’t do anything. Listen to the patient; ask the patient how aggressive they want to be with treatment. Be responsible for how you determine testing and treatment. Be focused with testing rather than running every test available.

Avoiding dogmatic protocols

There is a difference between process and protocols. When working with a patient, you have to treat them as an individual. So often, practitioners treat with standard protocols and they pigeonhole patients into one of their protocols based on their symptoms.

It’s not in the patient’s best interest to treat every SIBO patient the same. It’s not the best practice to treat every patient with adrenal fatigue the same. Protocols need to be customized to the individual for the most effective outcome.

Dedicate yourself to the process rather than attaching yourself to a specific protocol.

Determining testing

When treating a patient, you want to gather as much information as you can in order to best treat the patient. You do this through a really detailed intake form, and asking the patient a lot of questions. Testing is another way to gather information, but to make it cost-effective for the patient you want to be specific with your testing recommendations.

The point of testing is to determine treatment. So avoid unnecessary testing in which the outcome has not been proven to determine the treatment type. For example, doing a stool test to determine what type of probiotic a patient should take is unproven. There are no studies supporting this. Just because your stool test comes back showing you’re low in bifido infantis does not necessarily mean your treatment should be to take bifido infantis probiotic. Rather, just try a probiotic and see how it works.

Thyroid testing is helpful when someone presents with thyroid symptoms. However, you usually don’t need a comprehensive thyroid panel. Typically, basic thyroid testing is enough.

Often times in functional medicine we’re doing things that are excessive but not necessarily effective.

What’s next in functional medicine?

The next step for functional medicine is to start specializing. This may seem to contradict the concept of functional medicine since the objective is to treat root causes and address the entire body as a whole.

While this is true, it’s important to realize that we can’t be experts in everything. It’s very difficult to know everything there is to know about the gut, adrenals, endocrine system, brain, mold toxicity, genetics, chronic Lyme, etc.

As a practitioner, find your main areas of focus and be an expert in those areas. That’s not to say you can’t help different patients. As a functional medicine practitioner, you will have some basic tools in your tool kit that most of your patients can benefit from.

However, there may be patients that have issues outside of your specialty and they’d do better if referred out. Cultivate relationships with other clinicians and practitioners that you can refer to once you’ve done your thorough job with the patient.

Make sure you always keep your patient moving forward.

If you need help getting started with functional medicine, click here

What do you think? I would like to hear your thoughts or experience with this.

Dr. Ruscio is your leading functional and integrative doctor specializing in gut related disorders such as SIBO, leaky gut, Celiac, IBS and in thyroid disorders such as hypothyroid and hyperthyroid. For more information on how to become a patient, please contact our office. Serving the San Francisco bay area and distance patients via phone and Skype.