This week on the Evolution of Medicine podcast we are sharing a special interview that was part of the "11 days of Global Unity" whch featured luminaires like Dr. Deepak Chopra, Ralph Nader and many more. This interview was originally conducted by Rick Ulfik from We, The World. He interviews Dr. Rangan Chatterjee and James Maskell about the work they are doing, the future of medicine, the current state of functional medicine, and how we see medicine shifting in the rest of this century. It was a great session, and at the time we received so much feedback that people enjoyed it. The interview has not been available since the Summit ended, so we wanted to share it in this podcast.

When the Roman Empire split into the Western and Eastern Empires, the Western Empire, centered on Rome, went into a deep decline and the art of medicine slowly slipped away, with the physicians becoming pale shadows of their illustrious predecessors and generally causing more harm than good. Western Europe would not appear again in the history of medicine until long after the decline of Islam.


Kan Aiya, a 60-year-old woman, had lost many loved ones to breast cancer. She had seen her sisters die of the cruel disease, so when a tumour formed in her left breast she was well aware of the likely outcome. For her, however, there was a chance of survival – an operation. It was 1804 and she was in the best possible place for surgery – feudal Japan.

Prize Citation: In “Digital Natives: How medical and Indigenous histories matter for Big Data,” Joanna Radin argues for critical engagement with “the metabolism of Big Data”. Radin presents the remarkable history of a dataset known as the Pima Indian Diabetes Dataset (PIDD), derived from research conducted with the Akimel O’odham Indigenous community in Arizona. Since the loss of their ability to farm the land, this community has an extremely high rate of diabetes. Reconstructing the circumstances of the dataset’s production and its presence in a Machine Learning repository where it is used in projects far removed from diabetes, Radin draws attention to the way that data is naturalised, and bodies and economic struggle are elided. Significant questions are raised about the ethics and politics of research in an age of Big Data, including the reproduction of patterns of settler colonialism in the research enterprise, and the community’s work to redefine the research encounter. The prize committee were impressed by Radin’s depth of research, quality of analysis, and the contribution to multiple literatures, and commend her for an inspired and inspiring article.

The Byzantine Empire's neighbors, the Persian Sassanid Empire, also made their noteworthy contributions mainly with the establishment of the Academy of Gondeshapur, which was "the most important medical center of the ancient world during the 6th and 7th centuries."[64] In addition, Cyril Elgood, British physician and a historian of medicine in Persia, commented that thanks to medical centers like the Academy of Gondeshapur, "to a very large extent, the credit for the whole hospital system must be given to Persia."[65]

Public health measures became particular important during the 1918 flu pandemic, which killed at least 50 million people around the world.[171] It became an important case study in epidemiology.[172] Bristow shows there was a gendered response of health caregivers to the pandemic in the United States. Male doctors were unable to cure the patients, and they felt like failures. Women nurses also saw their patients die, but they took pride in their success in fulfilling their professional role of caring for, ministering, comforting, and easing the last hours of their patients, and helping the families of the patients cope as well.[173]


I’m really excited to have James Maskell from Functional Forum and Revive Primary Care.  He’s also the director of the Evolution of Medicine Summit just coming up that I’m participating in.  I asked James to come on this show so we could chat about functional medicine and the future of medicine in general, because there are some really big and exciting changes happening in the world of medicine and functional medicine in particular, and James has his hands in a lot of different pots in this field.
The Department of the History of Medicine is the oldest such academic department in North America. We are dedicated to scholarship in the history of medicine, disease and the health sciences, and their relation to society. The Department seeks to bring historical perspectives to bear on contemporary health issues. Faculty members conduct research on a broad range of topics, time periods, and geographic areas. The Department offers a PhD in the History of Medicine.

Established by Congress in 1959 as the nation's highest scientific honor, the National Medal of Science is a presidential award given to individuals "deserving of special recognition by reason of their outstanding contributions to knowledge in the physical, biological, mathematical or engineering sciences." In 1980, Congress expanded this recognition to include the social and behavioral sciences.
Chris Kresser:  Hey, everybody.  Chris Kresser here.  I’m really excited to have James Maskell from Functional Forum and Revive Primary Care.  He’s also the director of the Evolution of Medicine Summit just coming up that I’m participating in.  I asked James to come on this show so we could chat about functional medicine and the future of medicine in general, because there are some really big and exciting changes happening in the world of medicine and functional medicine in particular, and James has his hands in a lot of different pots in this field.  He runs something called the Functional Forum, which is where functional medicine practitioners meet in New York—I think they’ll be meeting at some other places soon—to talk about these topics.  James will tell us a little bit more about the Evolution of Medicine Summit that’s coming up.  So welcome, James.  Happy to have you.
So much great stuff here in how to build a low overhead practice, some of the technology that she's learned how to use through the Evolution of Medicine Practice Accelerator, how to keep a low overhead practice, how to build a connection with local integrative providers that now pay her rent, and just so many other ways in which Sonza has built such an amazing practice. I think there's value in here, no matter what kind of practitioner you are, and I really hope you'll enjoy it. This is part of our Success Leaves Clues podcast series, enjoy.
The practice of medicine changed in the face of rapid advances in science, as well as new approaches by physicians. Hospital doctors began much more systematic analysis of patients' symptoms in diagnosis.[113] Among the more powerful new techniques were anaesthesia, and the development of both antiseptic and aseptic operating theatres.[114] Effective cures were developed for certain endemic infectious diseases. However the decline in many of the most lethal diseases was due more to improvements in public health and nutrition than to advances in medicine.
Elites and the popular classes alike called on divine intervention in personal and society-wide health crises, such as the epidemic of 1737. The intervention of the Virgin of Guadalupe was depicted in a scene of dead and dying Indians, with elites on their knees praying for her aid. In the late eighteenth century, the crown began implementing secularizing policies on the Iberian peninsula and its overseas empire to control disease more systematically and scientifically.[110][111][112]
During the Renaissance, understanding of anatomy improved, and the microscope was invented. Prior to the 19th century, humorism (also known as humoralism) was thought to explain the cause of disease but it was gradually replaced by the germ theory of disease, leading to effective treatments and even cures for many infectious diseases. Military doctors advanced the methods of trauma treatment and surgery. Public health measures were developed especially in the 19th century as the rapid growth of cities required systematic sanitary measures. Advanced research centers opened in the early 20th century, often connected with major hospitals. The mid-20th century was characterized by new biological treatments, such as antibiotics. These advancements, along with developments in chemistry, genetics, and radiography led to modern medicine. Medicine was heavily professionalized in the 20th century, and new careers opened to women as nurses (from the 1870s) and as physicians (especially after 1970).
Chris Kresser:  Yeah, that’s great.  The summit, it seems there’s so many great speakers, so many good topics.  I love that there’s a doctor practitioner track.  And I really encourage anyone who’s listening to this to check it out, because there’s a wealth of information there.  It’s really representative of what the future of medicine is going to be.  And there’s a lot of really practical, actionable information that you can use right now to improve your health.  So if you want to check it out, go to ChrisKresser.com/evomed.  That’s E-V-O-M-E-D, ChrisKresser.com/evomed.  And you can register for free for this summit.  You can watch all the talks for free, which is about as good as it gets.  And, yeah, go over there and sign up, and they’ll send you the schedule.
All the way through the Functional Forum and the Evolution of Medicine we've sighted the future of "primary care" to be enhanced through technology, the Functional Medicine operating systems, and coaching for behavior change and this is such a great example. One of the powerful tools that Powell has taken advantage is Nudge Coach, a behavior change technology we love. By taking advantage of their white label solution, they have a branded experience for their patients to use to track behavior change between visits.
We've brought her back because her practice is now a huge success.  She's implemented many of the things that we speak about in the 60 Day Practice Accelerator program and the Functional Forum.  James, as a member of her practice, has witnessed it firsthand.  Dr. Berzin is now opening more practices and looking for more physicians to bring on board.

The Ayurvedic classics mention eight branches of medicine: kāyācikitsā (internal medicine), śalyacikitsā (surgery including anatomy), śālākyacikitsā (eye, ear, nose, and throat diseases), kaumārabhṛtya (pediatrics with obstetrics and gynaecology), bhūtavidyā (spirit and psychiatric medicine), agada tantra (toxicology with treatments of stings and bites), rasāyana (science of rejuvenation), and vājīkaraṇa (aphrodisiac and fertility). Apart from learning these, the student of Āyurveda was expected to know ten arts that were indispensable in the preparation and application of his medicines: distillation, operative skills, cooking, horticulture, metallurgy, sugar manufacture, pharmacy, analysis and separation of minerals, compounding of metals, and preparation of alkalis. The teaching of various subjects was done during the instruction of relevant clinical subjects. For example, teaching of anatomy was a part of the teaching of surgery, embryology was a part of training in pediatrics and obstetrics, and the knowledge of physiology and pathology was interwoven in the teaching of all the clinical disciplines. The normal length of the student's training appears to have been seven years. But the physician was to continue to learn.[28]
A major breakthrough in epidemiology came with the introduction of statistical maps and graphs. They allowed careful analysis of seasonality issues in disease incidents, and the maps allowed public health officials to identify critical loci for the dissemination of disease. John Snow in London developed the methods. In 1849, he observed that the symptoms of cholera, which had already claimed around 500 lives within a month, were vomiting and diarrhoea. He concluded that the source of contamination must be through ingestion, rather than inhalation as was previously thought. It was this insight that resulted in the removal of The Pump On Broad Street, after which deaths from cholera plummeted afterwards. English nurse Florence Nightingale pioneered analysis of large amounts of statistical data, using graphs and tables, regarding the condition of thousands of patients in the Crimean War to evaluate the efficacy of hospital services. Her methods proved convincing and led to reforms in military and civilian hospitals, usually with the full support of the government.[138][139][140]
Today on the Evolution of Medicine podcast, we go back to the first Evolution of Medicine Summit with Dr. David Perlmutter, a renowned neurologist, brain health expert,  and best selling author. He joined us to speak about the ever important, gut brain connection. We review this presentation in preparation for the upcoming Functional Forum - The Evolution of Neurology where will be bring you the best highlights from the Institute for Functional Medicine Annual International Conference. 
Established by Congress in 1959 as the nation's highest scientific honor, the National Medal of Science is a presidential award given to individuals "deserving of special recognition by reason of their outstanding contributions to knowledge in the physical, biological, mathematical or engineering sciences." In 1980, Congress expanded this recognition to include the social and behavioral sciences.
When I sold the practice to my partner he converted the practice to a membership model and has continued to be successful, but with less patients and staff. I am now taking over and expanding a new practice and have asked both the owners to read this as we are transitioning the practice from a limited scope practice to a Functional Medicine practice. I have also recommended this book to friends who are looking to enjoy medicine again and are considering getting into Functional Medicine. I would strongly recommend this book to anyone wanting to get a better understanding of what Functional Medicine is and how to transition into a practice that will enable them to help many people that are today stuck in the cycle of disease = medication. This is not alternative medicine, it is a continuum of the science-based approach that those of us trained in western medicine have grown up in. The difference is it gives you the tools to "go upstream" and help patients to achieve true wellness. Once you start helping people at this level the biggest problem is having too many patients wanting to see you.
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