Chris Kresser:  Mm-hmm.  So let’s talk a little, since we’re on the topic, let’s talk a little bit more about scalability.  We’re actually, you mentioned combining higher-cost services with lower-cost services or personnel for implementation. I’m expanding my own clinic now and we’re getting ready.  I’ve hired an intern here that I’m training, and we’re going to be hiring, probably in the future, some nurse practitioners and physician assistants that can help to implement some of the treatment protocols that I’m designing and researching.  We’re using technology now a lot more efficiently with electronic health records, and handouts and documents that can be delivered through that on specific health conditions that patients have.  So rather than spending time clinically to talk them through these things, we can give them a handout or even direct them to a video or webinar to watch, which is a lot more time-efficient for me, and cost-efficient for them, because they’re not paying me to just tell them something that they could learn by watching a video or a webinar.  So what’s your take on how functional medicine will scale and become available?  And what role does technology play in that?
1953 James Watson and Francis Crick at Cambridge University describe the structure of the DNA molecule. Maurice Wilkins and Rosalind Franklin at King's College in London are also studying DNA. (Wilkins in fact shares Franklin's data with Watson and Crick without her knowledge.) Watson, Crick, and Wilkins share the Nobel Prize for Physiology or Medicine in 1962 (Franklin had died and the Nobel Prize only goes to living recipients).
Wes starts by sharing his own story of abuse and his journey to starting A Human Project. As he started to understand his own gut-brain connection and effects of the medications that were supposed to be helping him, he decided to take his life into his own hands. Now he focuses on helping children through things like stress, bullying and suicidal thoughts. We hope that this podcast inspires you as much as it has inspired us. Please consider supporting this very worthy cause at A Human Project.
Spearheaded by faculty in the HMS Department of Global Health and Social Medicine, a report by The Lancet Commission on Global Surgery reveals that 5 billion people are unable to access safe, timely and affordable surgery, leading to 18.6 million preventable deaths each year worldwide. The report also presents a blueprint for developing properly functioning surgical systems globally.
When the medicine of ancient Egypt is examined, the picture becomes clearer. The first physician to emerge is Imhotep, chief minister to King Djoser in the 3rd millennium bce, who designed one of the earliest pyramids, the Step Pyramid at Ṣaqqārah, and who was later regarded as the Egyptian god of medicine and identified with the Greek god Asclepius. Surer knowledge comes from the study of Egyptian papyri, especially the Ebers papyrus and Edwin Smith papyrus discovered in the 19th century. The former is a list of remedies, with appropriate spells or incantations, while the latter is a surgical treatise on the treatment of wounds and other injuries.
Mac shares how Nudge Coach provides an efficient and effective way to better coaching and accountability for patients once they step out of the doctor's office. If you've been following us for awhile, you know that we have now moved from the term "compliance" to "empowerment".  In this podcast, we discuss the difference between the two terms and how we have evolved passed some of the old verbiage into a new relationship between the patient and practitioner. 

Women had always served in ancillary roles, and as midwives and healers. The professionalization of medicine forced them increasingly to the sidelines. As hospitals multiplied they relied in Europe on orders of Roman Catholic nun-nurses, and German Protestant and Anglican deaconesses in the early 19th century. They were trained in traditional methods of physical care that involved little knowledge of medicine. The breakthrough to professionalization based on knowledge of advanced medicine was led by Florence Nightingale in England. She resolved to provide more advanced training than she saw on the Continent. At Kaiserswerth, where the first German nursing schools were founded in 1836 by Theodor Fliedner, she said, "The nursing was nil and the hygiene horrible."[119]) Britain's male doctors preferred the old system, but Nightingale won out and her Nightingale Training School opened in 1860 and became a model. The Nightingale solution depended on the patronage of upper class women, and they proved eager to serve. Royalty became involved. In 1902 the wife of the British king took control of the nursing unit of the British army, became its president, and renamed it after herself as the Queen Alexandra's Royal Army Nursing Corps; when she died the next queen became president. Today its Colonel In Chief is Sophie, Countess of Wessex, the daughter-in-law of Queen Elizabeth II. In the United States, upper middle class women who already supported hospitals promoted nursing. The new profession proved highly attractive to women of all backgrounds, and schools of nursing opened in the late 19th century. They soon a function of large hospitals, where they provided a steady stream of low-paid idealistic workers. The International Red Cross began operations in numerous countries in the late 19th century, promoting nursing as an ideal profession for middle class women.[120]


Kitasato Shibasaburō (1853–1931) studied bacteriology in Germany under Robert Koch. In 1891 he founded the Institute of Infectious Diseases in Tokyo, which introduced the study of bacteriology to Japan. He and French researcher Alexandre Yersin went to Hong Kong in 1894, where; Kitasato confirmed Yersin's discovery that the bacterium Yersinia pestis is the agent of the plague. In 1897 he isolates and described the organism that caused dysentery. He became the first dean of medicine at Keio University, and the first president of the Japan Medical Association.[147][148]
Magic and religion played a large part in the medicine of prehistoric or early human society. Administration of a vegetable drug or remedy by mouth was accompanied by incantations, dancing, grimaces, and all the tricks of the magician. Therefore, the first doctors, or “medicine men,” were witch doctors or sorcerers. The use of charms and talismans, still prevalent in modern times, is of ancient origin.
After 1871 Berlin, the capital of the new German Empire, became a leading center for medical research. Robert Koch (1843–1910) was a representative leader. He became famous for isolating Bacillus anthracis (1877), the Tuberculosis bacillus (1882) and Vibrio cholerae (1883) and for his development of Koch's postulates. He was awarded the Nobel Prize in Physiology or Medicine in 1905 for his tuberculosis findings. Koch is one of the founders of microbiology, inspiring such major figures as Paul Ehrlich and Gerhard Domagk.[127]

Evolutionary principles may also improve our vaccine strategy. Vaccines are another way to create selective pressures on infectious organisms. We may inadvertently target vaccines against proteins that select out less virulent strains, selecting for the more virulent or infectious strains. Understanding of this allows us to instead target vaccines against virulence without targeting less deadly strains.

We begin this new series with Sandra Scheinbaum, PhD, founder of the Functional Medicine Coaching Academy. Sandy shares with us how health coaches contribute to the success of a medical practice and what roles they can play to connect with patients and the local community. She also provides guidance on how to transition to an integrative practice that utilizes a health coach. 


1897 Ronald Ross, a British officer in the Indian Medical Service, demonstrates that malaria parasites are transmitted via mosquitoes, although French army surgeon Charles Louis Alphonse Laveran identified parasites in the blood of a malaria patient in 1880. The treatment for malaria was identified much earlier (and is still used today). The Qinghao plant (Artemisia annua) was described in a Chinese medical treatise from the 2nd century BCE; the active ingredient, known as artemisinin, was isolated by Chinese scientists in 1971 and is still used today. The more commonly known treatment, quinine, was derived from the bark of a tree called Peruvian bark or Cinchona and was introduced to the Spanish by indigenous people in South America during the 17th century.
Western conceptions of the body differ significantly from indigenous knowledge and explanatory frameworks in Asia. As colonial governments assumed responsibility for health care, conceptions of the human body were translated into local languages and related to vernacular views of health, disease, and healing. The contributors to this volume chart and analyze the organization of western medical education in Southeast Asia, public health education in the region, and the response of practitioners of “traditional medicine”.
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.
Evolutionary medicine or Darwinian medicine is the application of modern evolutionary theory to understanding health and disease. Modern medical research and practice have focused on the molecular and physiological mechanisms underlying health and disease, while evolutionary medicine focuses on the question of why evolution has shaped these mechanisms in ways that may leave us susceptible to disease. The evolutionary approach has driven important advances in our understanding of cancer,[1] autoimmune disease,[2] and anatomy.[3] Medical schools have been slower to integrate evolutionary approaches because of limitations on what can be added to existing medical curricula.[4]
This is a security feature. Do not change this feature unless the scope of the change is fully understood. You should take a network trace before changing this value to confirm that the request is not malicious. If double escape sequences are allowed by the server, modify the configuration/system.webServer/security/requestFiltering@allowDoubleEscaping setting. This could be caused by a malformed URL sent to the server by a malicious user.
German physician Robert Koch, noting fellow German Ferdinand Cohn's report of a spore stage of a certain bacterial species, traced the life cycle of Davaine's bacteridia, identified spores, inoculated laboratory animals with them, and reproduced anthrax—a breakthrough for experimental pathology and germ theory of disease. Pasteur's group added ecological investigations confirming spores' role in the natural setting, while Koch published a landmark treatise in 1878 on the bacterial pathology of wounds. In 1881, Koch reported discovery of the "tubercle bacillus", cementing germ theory and Koch's acclaim.
Emil Kraepelin (1856–1926) introduced new medical categories of mental illness, which eventually came into psychiatric usage despite their basis in behavior rather than pathology or underlying cause. Shell shock among frontline soldiers exposed to heavy artillery bombardment was first diagnosed by British Army doctors in 1915. By 1916, similar symptoms were also noted in soldiers not exposed to explosive shocks, leading to questions as to whether the disorder was physical or psychiatric.[166] In the 1920s surrealist opposition to psychiatry was expressed in a number of surrealist publications. In the 1930s several controversial medical practices were introduced including inducing seizures (by electroshock, insulin or other drugs) or cutting parts of the brain apart (leucotomy or lobotomy). Both came into widespread use by psychiatry, but there were grave concerns and much opposition on grounds of basic morality, harmful effects, or misuse.[167]
Some 200 years later another doctor, Peseshet, was immortalised on a monument in the tomb of her son, Akhet-Hetep (aka Akhethetep), a high priest. Peseshet held the title ‘overseer of female physicians’, suggesting that women doctors weren’t just occasional one-offs. Peseshet herself was either one of them or a director responsible for their organisation and training.
She came to our recent Functional Forum in San Francisco and afterwards approached us with some great ideas about how we can make the Functional Forum more approachable for those with social anxiety.  If you've seen the forum, you know that Gabe and James are not introverted by any stretch of the imagination, so, it was great to learn from the experience of others.
Contemporary humans in developed countries are mostly free of parasites, particularly intestinal ones. This is largely due to frequent washing of clothing and the body, and improved sanitation. Although such hygiene can be very important when it comes to maintaining good health, it can be problematic for the proper development of the immune system. The hygiene hypothesis is that humans evolved to be dependent on certain microorganisms that help establish the immune system, and modern hygiene practices can prevent necessary exposure to these microorganisms. "Microorganisms and macroorganisms such as helminths from mud, animals, and feces play a critical role in driving immunoregulation" (Rook, 2012[26]). Essential microorganisms play a crucial role in building and training immune functions that fight off and repel some diseases, and protect against excessive inflammation, which has been implicated in several diseases. For instance, recent studies have found evidence supporting inflammation as a contributing factor in Alzheimer's Disease.[27]
Georg Ebers papyrus from the U. S. National Medical Library at the National Institutes of Health. This papyrus recounts the case of a "tumor against the god Xenus." The recommendation is to "do thou nothing there against." It is also noted that the heart is the center of the blood supply, with vessels attached for every member of the body. (Public Domain)
Upon the outbreak of a cholera epidemic in Alexandria, Egypt, two medical missions went to investigate and attend the sick, one was sent out by Pasteur and the other led by Koch.[116] Koch's group returned in 1883, having successfully discovered the cholera pathogen.[116] In Germany, however, Koch's bacteriologists had to vie against Max von Pettenkofer, Germany's leading proponent of miasmatic theory.[117] Pettenkofer conceded bacteria's casual involvement, but maintained that other, environmental factors were required to turn it pathogenic, and opposed water treatment as a misdirected effort amid more important ways to improve public health.[117] The massive cholera epidemic in Hamburg in 1892 devastasted Pettenkoffer's position, and yielded German public health to "Koch's bacteriology".[117]

When the medicine of ancient Egypt is examined, the picture becomes clearer. The first physician to emerge is Imhotep, chief minister to King Djoser in the 3rd millennium bce, who designed one of the earliest pyramids, the Step Pyramid at Ṣaqqārah, and who was later regarded as the Egyptian god of medicine and identified with the Greek god Asclepius. Surer knowledge comes from the study of Egyptian papyri, especially the Ebers papyrus and Edwin Smith papyrus discovered in the 19th century. The former is a list of remedies, with appropriate spells or incantations, while the latter is a surgical treatise on the treatment of wounds and other injuries.


^ Bynum, W.F. (1974). "Rationales for therapy in British psychiatry: 1780–1835". Medical History. 18 (4): 317–34. doi:10.1017/s0025727300019761. PMC 1081592. PMID 4618306.; Digby, Anne (1988). "Moral Treatment at the Retreat 1796–1846". In Porter, Roy; Bynum, W.F.; Shepherd, Michael. The Anatomy of Madness: Essays in the History of Psychiatry. 2. London & New York: Tavistock. pp. 52–71. ISBN 978-0415008594.

c.130 CE Birth of Galen, considered by many to be the most important contributor to medicine following Hippocrates. Born of Greek parents, Galen resides primarily in Rome where he is physician to the gladiators and personal physician to several emperors. He publishes some 500 treatises and is still respected for his contributions to anatomy, physiology, and pharmacology.
As you pointed out, 80% just want a prescription and are not willing to find the causes of their illness, I have chosen to focus on the 20% who are willing to discover the causes and make lifestyle changes. Patient satisfaction is up, and I am getting control back of my practice. I believe this the medicine of the future, that will appeal to my grandchildren.
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