Great overview of what it takes to learn and run a Functional Medicine (science-based, systems biology, Integrative) medical practice. I started a Functional Medicine practice in 2009. I wish this book was and approach was available then. There were a lot of growing pains, many of which may have been avoided with the best practices approach outlined in this book. We started out in a fully insurance based practice and at 5 years we were very successful. However, we were also very burnt out. We had talked about creating a model that could be used to help providers make the switch. The bottom line in my experience is that most people can't do that when they're in the trenches seeing patients and learning by trial and error. We never advertised after the initial announcement that we were opening. From there it is was all word of mouth.
During the U.S. Civil War the Sanitary Commission collected enormous amounts of statistical data, and opened up the problems of storing information for fast access and mechanically searching for data patterns. The pioneer was John Shaw Billings (1838–1913). A senior surgeon in the war, Billings built the Library of the Surgeon General's Office (now the National Library of Medicine), the centerpiece of modern medical information systems.[142] Billings figured out how to mechanically analyze medical and demographic data by turning facts into numbers and punching the numbers onto cardboard cards that could be sorted and counted by machine. The applications were developed by his assistant Herman Hollerith; Hollerith invented the punch card and counter-sorter system that dominated statistical data manipulation until the 1970s. Hollerith's company became International Business Machines (IBM) in 1911.[143]
c.484 – 425 BC Herodotus tells us Egyptian doctors were specialists: Medicine is practiced among them on a plan of separation; each physician treats a single disorder, and no more. Thus the country swarms with medical practitioners, some undertaking to cure diseases of the eye, others of the head, others again of the teeth, others of the intestines,and some those which are not local.[2]
Across Europe medical schools relied primarily on lectures and readings. The final year student would have limited clinical experience by trailing the professor through the wards. Laboratory work was uncommon, and dissections were rarely done because of legal restrictions on cadavers. Most schools were small, and only Edinburgh, Scotland, with 11,000 alumni, produced large numbers of graduates.[99][100]
Founder and currently Executive Editor of Science-Based Medicine Steven Novella, MD is an academic clinical neurologist at the Yale University School of Medicine. He is also the host and producer of the popular weekly science podcast, The Skeptics’ Guide to the Universe, and the author of the NeuroLogicaBlog, a daily blog that covers news and issues in neuroscience, but also general science, scientific skepticism, philosophy of science, critical thinking, and the intersection of science with the media and society. Dr. Novella also has produced two courses with The Great Courses, and published a book on critical thinking - also called The Skeptics Guide to the Universe.
This week on the Evolution of Medicine podcast, we feature Steven Feyrer-Melk, PhD, co-founder of a preventative cardiology practice, The Optimal Heart Center and Chief Science Officer of Nudge Coach, a lifestyle medicine technology company. Nudge has sponsored the Functional Forum and the Evolution of Medicine podcast in the past year and has worked with us to bring our community of practitioners a valuable addition to their practices that allows every patient to feel supported at all times.
Bodies from the Stone Age show signs of medical treatment: broken limbs that have been set and healed, dislocations replaced and wounds treated successfully. Bone needles from the Upper Palaeolithic (c.30,000 years ago) may indicate that wounds were stitched (sutured) at this time. A widespread practice from the late Palaeolithic, which flourished in Neolithic Europe (c.7,000 years ago), was trepanation (making a hole through the frontal or parietal bones of the skull). Whilst the reasons for this practice are unknown, the high survival rate of patients, indicated by the healing and remodelling of bone, proves great technical skill. Major blood vessels in the skull had to be avoided, haemorrhage was minimised by turning back the flaps of skull created by the incision and the operation site had to be kept free from infection.
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.

Scientists, led by Deborah Hung in the HMS Department of Microbiology and Immunobiology and at Mass General and Brigham and Women’s, show that a detailed RNA signature of specific pathogens can identify a broad spectrum of infectious agents, forming the basis of a diagnostic platform to earlier determine the best treatment option for infectious diseases.
The week on the Evolution of Podcast, we welcome Dr. Elson Haas, leader in the field of integrative medicine. After four decades of practicing integrative medicine in the insurance model, he provides us with some great insights into how he is able keep is practice going.​​ Dr. Haas' latest book Staying Healthy with NEW Medicine gives some insights on natural, Eastern, Western concepts into something that is truly useful for the modern practitioner and the modern patient. 
The Greek Galen (c. 129–216 CE) was one of the greatest physicians of the ancient world, studying and traveling widely in ancient Rome. He dissected animals to learn about the body, and performed many audacious operations—including brain and eye surgeries—that were not tried again for almost two millennia. In Ars medica ("Arts of Medicine"), he explained mental properties in terms of specific mixtures of the bodily parts.[51][52]
The means of dressing the incision was also highly developed: the surgeon used seven polished iron spikes to bring the edges of the wound together, tying them in place with bark-cloth string. He then applied a thick layer of herbal paste and covered this with a warm banana leaf held in place with a bandage. According to Felkin’s account, the mother and her baby were still doing well when he left the village 11 days later.
This week, we feature the keynote presentation from the summit by Dr. Jeffrey Bland. You can get this talk and many other gifts by registering for the summit. In his talk, Dr. Jeffrey Bland shares his view of the current state of genetics. Even If you're not interested in genetic testing, we hope that you will take a few minutes and listen to the godfather of functional medicine, as he shares his thoughts on genomics and why it will be the catalyst for functional medicine to become the operating system for a new era of predictive preventative medicine.
Chris Kresser:  So what kind of response are you getting?  I mean, it sounds like, just from the little bit that I’ve heard, that this is really happening at a big level, with The Huffington Post support.  You know, this is getting beyond the typical kind of blog tour that a lot of these summits do.  So what’s been the response in the more mainstream world to the whole concept of functional medicine and doing a summit on this topic?
James Maskell:  Cool.  I’d love to leave your listeners with something just to get them thinking, Chris, before the summit comes up.  Because we did have one talk that I think is going to really change people’s thoughts on a lot of things.  You know, a lot of it is great information, but I know that you’re passionate about the biome, the microbiome, and our understanding of germs.  But if you don’t mind, I’d love to just share one concept that was shared that I think that you’ll really like.  I’d love to get your comment on it.
The medicinal leech has been in use for thousands of years, and is even today considered to be a way of restoring venous circulation after reconstructive surgery. But it was in the early 19th century that the leech really soared in popularity. Led by French physician François-Joseph-Victor Broussais (1772–1838), who postulated that all disease stemmed from local inflammation treatable by bloodletting, the ‘leech craze’ saw barrels of the creatures shipped across the globe, wild leech populations decimated almost to extinction, and the establishment of prosperous leech farms.
The operation, Felkin reported, was carried out with the intention of saving both lives. The mother was partially anaesthetised with banana wine. The surgeon also used this wine to wash the surgical site and his own hands, suggesting awareness of the need for infection control measures. He then made a vertical incision, going through the abdominal wall and part of the uterine wall, before further dividing the uterine wall enough to take the baby out. The operation also involved removing the placenta and squeezing the uterus to promote contraction.
The World Health Organization was founded in 1948 as a United Nations agency to improve global health. In most of the world, life expectancy has improved since then, and was about 67 years as of 2010, and well above 80 years in some countries. Eradication of infectious diseases is an international effort, and several new vaccines have been developed during the post-war years, against infections such as measles, mumps, several strains of influenza and human papilloma virus. The long-known vaccine against Smallpox finally eradicated the disease in the 1970s, and Rinderpest was wiped out in 2011. Eradication of polio is underway. Tissue culture is important for development of vaccines. Though the early success of antiviral vaccines and antibacterial drugs, antiviral drugs were not introduced until the 1970s. Through the WHO, the international community has developed a response protocol against epidemics, displayed during the SARS epidemic in 2003, the Influenza A virus subtype H5N1 from 2004, the Ebola virus epidemic in West Africa and onwards.
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]

It didn’t work against Roman armies, however, and when Mithradates was defeated by the military leader Pompey in 66 BC, the recipe supposedly arrived in Rome. Emperor Nero’s physician Andromachus developed it into a 64-ingredient composition, which became known as theriac. Most of the ingredients were botanical (including opium), but viper’s flesh was a notable component.
Another of Hippocrates's major contributions may be found in his descriptions of the symptomatology, physical findings, surgical treatment and prognosis of thoracic empyema, i.e. suppuration of the lining of the chest cavity. His teachings remain relevant to present-day students of pulmonary medicine and surgery. Hippocrates was the first documented person to practise cardiothoracic surgery, and his findings are still valid.

We welcome Dr. Sonza Curtis as part of our Success Leaves Clues. Dr. Curtis graduated from the University of Nebraska Medical Center, with a Masters of Science in Physician Assistant Studies.  She then went on to complete her Doctorate of Naturopathy for Health Care Professionals.  In 2014, Dr. Curtis became one of only three Georgia doctors Certified in Functional Medicine.
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