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?
This has been a huge acceleration for our organization. James published his book The Evolution of Medicine. We launched the Evolution of Medicine Practice Accelerator and as always, we've had our monthly the Functional Forum episodes. We've recently introduced the "Future of Functional in 5" which allows our community of practitioners to share their stories and gifts with the whole community. Our Functional Forum meetups continue to facilitate collaboration and community building for practitioners on a local level. James and Gabe also discuss what's new for the Evolution of Medicine and share details about a course on building a Functional Membership practice, as well as bringing new doctors into our community consistently.
But the most impactful change to the old system is the transition to patient-centered diagnoses. Medicine evolving from a doctor-centered structure to a patient-centered structure and this reflects Dr. Galland's unique contribution to the operating system. In this podcast, Dr. Galland addresses how this new model was developed and why it's such an important part of the evolution of medicine.
Sushruta advises his students that however well read they are, they are not competent to treat disease until they have practical experience. Surgical incisions were to be tried out on the skin of fruits, while carefully extracting fruit seeds enabled the student to develop the skill of removing foreign bodies from flesh. They also practised on dead animals and on leather bags filled with water, before being let loose on real patients.
The hygiene of the training and field camps was poor, especially at the beginning of the war when men who had seldom been far from home were brought together for training with thousands of strangers. First came epidemics of the childhood diseases of chicken pox, mumps, whooping cough, and, especially, measles. Operations in the South meant a dangerous and new disease environment, bringing diarrhea, dysentery, typhoid fever, and malaria. There were no antibiotics, so the surgeons prescribed coffee, whiskey, and quinine. Harsh weather, bad water, inadequate shelter in winter quarters, poor policing of camps, and dirty camp hospitals took their toll.
In the Middle Ages monasteries had sanitation. Streams provided clean water. Dirty water was used to clear toilets, which were in a separate room. Monks also had a room called a laver where they washed their hands before meals. However for most people sanitation was non-existent. In castles the toilet was simply a long passage built into the thickness of the walls. Often it emptied into the castle moat. Despite the lack of public health many towns had public bath-houses were you could pay to have a bath.
Temples dedicated to the healer-god Asclepius, known as Asclepieia (Ancient Greek: Ἀσκληπιεῖα, sing. Ἀσκληπιεῖον, 'Asclepieion), functioned as centers of medical advice, prognosis, and healing. At these shrines, patients would enter a dream-like state of induced sleep known as enkoimesis (ἐγκοίμησις) not unlike anesthesia, in which they either received guidance from the deity in a dream or were cured by surgery. Asclepeia provided carefully controlled spaces conducive to healing and fulfilled several of the requirements of institutions created for healing. In the Asclepeion of Epidaurus, three large marble boards dated to 350 BCE preserve the names, case histories, complaints, and cures of about 70 patients who came to the temple with a problem and shed it there. Some of the surgical cures listed, such as the opening of an abdominal abscess or the removal of traumatic foreign material, are realistic enough to have taken place, but with the patient in a state of enkoimesis induced with the help of soporific substances such as opium. Alcmaeon of Croton wrote on medicine between 500 and 450 BCE. He argued that channels linked the sensory organs to the brain, and it is possible that he discovered one type of channel, the optic nerves, by dissection.
The History of Medicine Collections in the David M. Rubenstein Rare Book & Manuscript Library at Duke University is accepting applications for our travel grant program. https://library.duke.edu/rubenstein/history-of-medicine/grants Research grants of up to $1,500 will be offered to researchers whose work would benefit from access to the historical medical collections at the Rubenstein Rare Book & […]
I ended up selling the practice to my partner and taking a 20-month sabbatical due to a motor vehicle accident. I had considered retiring after selling the practice, but in the area where I live there are very few people practicing this style of medicine and the need far exceeds the number of people who have the skills or knowledge. During the time I was not working, I had many former patients contacting me and wanting to know when I was going to open a new practice.