Health is Holistic: How we can treat the whole patient

Holistic health does not mean mixing up herbs in the back room (hello old apothecaries!) or drinking tinctures. It also does not mean that you forego medicine entirely. 

A holistic approach centers on treating the whole person to achieve optimal health. The focus is not just on the physical state, but also the mind and emotions including a person’s mental capacity for change, expectations and barriers, and their spiritual health meaning what is their connection to others, what support do they have, and do they have a community they belong to? 

What’s Functional Medicine? 

When I think of conventional medicine, I think of doctor’s diagnosing through lab tests, scans, and analyzing symptoms and then prescribing a treatment which could consist of some sort of lifestyle changes, prescribed medications, surgery or another intervention specific to that diagnosis. Often in pharmacy, we see prescriptions prescribed for symptoms of diseases or other medications. For example, a patient is prescribed a constipation-causing medicine and then a laxative and stool softener are added.

Often, a patients will start out at a family medicine or internal medicine practitioner for their ailment and then get referred to a specialist for one disorder (say cardiovascular health) and then go to another specialist for something else (an endocrine disorder). 

Now not all physicians are able to specifically treat every disease - being highly specialized means they have an expertise knowledge of certain body systems, but an ophthalmologist wouldn’t necessarily be able to practice as an OB/GYN . We know this as pharmacists as we are bound by prescriptive law in some states and scenarios to fill a prescription within the prescriber’s scope of expertise.

Functional medicine approaches the patient a little differently.

Functional medicine is a movement that focuses on treating the root cause of a condition or illness, rather than only addressing the symptoms.  Now, conventional medicine looks for the root cause too, very much so. However, the process with functional medicine is a little more mind, body, spirit.

According to the Institute of Functional Medicine:

“Functional Medicine is a systems biology–based approach that focuses on identifying and addressing the root cause of disease. Each symptom or differential diagnosis may be one of many contributing to an individual’s illness.” 

Functional medicine isn’t new by any means. One of the distinguishing factors between MDs and DOs is whether or not pieces of functional medicine are built into their course of training. For DOs, this school of thought isn’t new. For others, it may be revolutionary and a total game-changer.

The goal of functional medicine is to treat the whole patient. That means addressing their lifestyle, mental health, diet, exercise routine, and medical history all at once. Instead of treating a small set of conditions and symptoms, suddenly, the entire patient is getting stellar care. Functional medicine does not mean you are throwing away conventional medicine, but rather, you are diving into symptoms, behaviors, habits, biomarkers, etc… of this specific patient and making your recommendations on that.

The result? Patients received more individualized care and experienced better outcomes too.

Is Functional Medicine Different than Integrative Medicine?

Functional and Integrative medicine have a lot of similarities and a few key differences. The differences being that integrative medicine combines traditional treatments (the medicine that we’ve learned through school) with alternative therapies like detoxification, reducing medications, use of herbals, supplements, and naturopathic medicine, and regenerative medicine.

Functional medicine may go more into genetic and biochemical makeup (we are all different!) and focuses heavily on lifestyle changes like nutrition, sleep, stress management and physical activity. This may involve acupuncture, yoga, and massage.

Both schools of thought treat the whole patient.

Treating the Whole Patient

We are trained to help our patients live safe, healthy and comfortable lives. We double check their prescriptions to make sure they are getting the right dosage and that there aren’t any dangerous interactions. We listen to them and hear their concerns before offering advice. I think in many cases we do practice functional medicine without even realizing it. Usually we are one of the only health practitioners who has their whole medication list in front of us (though this is improving A LOT partly due to the medication management Joint Commission initiative). We are also trained and taught to ask and counsel on supplements as they may cause drug interactions too.

When I was counseling diabetics in a family medicine clinic, nutrition and exercise were huge counseling points. When we talk to patients about heart disease, cholesterol, and other disorders, we often ask about their nutrition and exercise habits. Same with depression, we ask about nutrition, stress management and exercise.

Now, it’s time to take that care to the next level by thinking about the whole patient. It’s time to step away from thinking about things as solutions to symptoms and focus on all the possible factors that could be contributing. With some critical thinking, we can start to make suggestions that help the patient much more than if we just dispensed the medication.

How we can take this approach:

When a patient comes in with a chronic prescription for Ambien, we can dig a little deeper into their sleep hygiene

When a patient comes in with their diabetes medicine, we can talk to them about lifestyle modifications

When a patient comes in with an anxiety or antidepressant, we can just ask them how they are doing! Sometimes, a little support system goes a long way.

The Ever-Changing Role of Pharmacists

Being a pharmacist has long been considered a traditional and well-respected role in the community. We provide a necessary service that helps doctors and hospital systems care for everyone.

Over the years, however, our level of community involvement has changed A LOT. We’re everywhere now, not just standing behind the counter at local pharmacies. Our growing involvement with the community has meant that there are more non-traditional roles and specialties than ever (even CVS has acknowledged this!).

We are able to specialize and help patients in ways that go beyond handing over a prescription. Now, patients are looking to us for advice and guidance especially as functional and integrative medicine are becoming more mainstream. And we need to step up to the plate.

Since part of our job description is keeping up with healthcare trends to continue to provide the best possible care, it's time to start thinking about how we fit in with functional medicine and how we can ensure our patients get the best outcomes. There are certificates, books and literature about these topics. Now, we don’t have to necessarily “subscribe” and “buy in” to every holistic approach. That probably would not be responsible. But we do need to be knowledgeable and know where we fit in. Providing information about exercise routines, smoking cessation, nutrition and stress management will make our patients healthier.