RHR Replay: Why Functional Medicine Is the Solution for Both Patients and Practitioners, with Tracey O’Shea
In this episode, we discuss:
- What is Functional Medicine?
- What’s wrong with the conventional healthcare system
- How Functional Medicine provides meaningful and rewarding work for healthcare practitioners
- The ADAPT Functional Medicine Practitioner Training Program benefits and curriculum
- How you can learn more about this year’s ADAPT Functional Medicine Practitioner Training Program enrollment dates
Show notes:
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Hey, everybody, Chris Kresser here. Welcome to another episode of Revolution Health Radio. This week, I’m excited to welcome back Tracey O’Shea, Functional Nurse Practitioner.
Tracey, as you may know from previous shows, has worked very closely with me over many years, side by side, in my clinic, [the] California Center for Functional Medicine, and then more recently as the director of the ADAPT Functional Medicine Practitioner Training Program. And in this show, we’re going to talk a little bit more about Functional Medicine. We have a lot of new listeners who are perhaps less familiar with Functional Medicine, what it is, what it has to offer, how it addresses the shortcomings of conventional medicine, and, most importantly, what it has to offer for both patients and practitioners.
There’s been some pretty exciting new developments in the Functional Medicine space, including Functional Medicine being featured on the Today Show very recently, and it is also serving as the operating system now for many new telehealth, digital, diagnostic, and digital therapeutic startup companies, many of which are venture-funded and getting a lot of attention in the media. So it’s a really exciting time for those of us in the Functional Medicine space, and I thought it would be a good opportunity to revisit some of the basics, talk about some of the new developments that are happening in the field, and for those [who] are practitioners and health professionals, how you can get trained as a Functional Medicine provider. So, I hope you enjoy the show. Let’s dive in.
Chris Kresser: Tracey, [it’s] so good to have you back on the show. Happy you could join me.
Tracey O’Shea: Yes, I’m happy to be here. Thanks, Chris.
Chris Kresser: So it’s been a while since we have done a basic introduction to Functional Medicine. And Tracey, as you know, we have a lot of practitioners in our audience—doctors and other healthcare providers—and also very savvy people who use Functional Medicine themselves, have a Functional Medicine doctor or clinician, or they’re interested in doing that. And it’s been a while since we’ve had a show that covers the basics of what Functional Medicine is, why it’s helpful, [and] why you might want to know about it, whether you’re a patient or a practitioner. And then, if you’re a practitioner, how do you actually learn more about it if you’re interested, and how do you build a career in Functional Medicine? [I’m] excited to talk about this with you. Let’s dive in.
Tracey O’Shea: Great. I’m really looking forward to it.
Chris Kresser: I would wager [that] certainly all of our long-term listeners know about Functional Medicine, but we have [new] people joining all the time. Ten years ago, or even five years ago, people would ask me what I did, and I’d say, “Functional Medicine,” [and] they would be like, “What’s that?” Or they would think it was something totally different than it actually was. People had all kinds of ideas, like [it was] some kind of physical therapy modality, or I don’t [even] know what. What kind[s] of responses did you get?
Tracey O’Shea: I think I would always be practicing my elevator speech to people of “Okay, how can I not bore them to death, but [that] they [would] also totally understand and get what Functional Medicine is and why I’m so proud to practice it. And what’s the difference in importance?” But yeah, I would get all kinds of stuff. Mostly just confused faces as I started to explain [it]. But it really feels like things have shifted pretty dramatically over the last few years, especially the awareness of the need for something different in our healthcare system. And just the [term] “Functional Medicine” is really starting to become more recognized.
Chris Kresser: Well, it was just on the Today Show.
Tracey O’Shea: I saw that. I was sharing it with literally everyone I knew. Just in case you missed this. That’s big time, I think.
Chris Kresser: Yeah, it’s great. It was a feature on Dr. Cynthia Lee, who’s fantastic. She is [a] fellow Bay Area [Functional Medicine practitioner]. Of course, now I’m a former Bay Area Functional Medicine practitioner, but she is a fellow Bay Area Functional [Medicine] practitioner and just a wonderful person and wonderful practitioner. She wrote a great book about her own healing journey and her use of Functional Medicine, and then what led her to pursue Functional Medicine as a doctor. As a professional, not just in her own healing journey. What led her to want to practice Functional Medicine herself. So yeah, now you’ve got Functional Medicine on the Today Show. Of course, several years ago, I was on Dr. Oz and several other national media programs. So it’s come a long way in the 25, 30 plus years since it came together as a modern discipline. And despite that progress, I think there’s still a lot of room to grow and a lot of people who don’t really understand what it is, [who] maybe have heard of it but [are] still not totally sure what it is.
What Is Functional Medicine?
Chris Kresser: So, I’m going to talk a little bit about it briefly here because I think it’s so important for us to make the changes that Functional Medicine offers as a possible approach to the healthcare crisis that we’re dealing with. Everybody listening to this knows [that] chronic disease is on the rise. We have six in 10 people with a chronic disease now and four in 10 people with multiple chronic diseases. Chronic disease accounts for seven of 10 deaths, which is really different than it used to be. [At] the turn of the 20th century, most deaths were caused by acute infectious diseases or trauma or injuries. Those were all really short-term things. As life expectancy has increased and as the modern world, with highly processed and refined food, greater exposure to toxins, less sleep, [and] all the things that we struggle with in our day-to-day modern lives, that [have] increased rates of chronic disease. Chronic disease is really eroding our quality of life, [and] it’s threatening to bankrupt our healthcare system. And the conventional medical model, as we know it, is woefully equipped to deal with it. I think everybody who’s listening to this has [experienced] that, or most people have had an experience like that, where they’ve had some kind of health complaint and they’ve gone to the doctor, and the doctor almost always is well-meaning and is doing their best to help, but they’re just really not trained to deal with the chronic complaints that are really interfering with most people’s lives. Outside of prescribing a medication in a 10- to 12-minute appointment, there’s not that much more that can be done to address these chronic complaints [within the conventional medical model].
This is the challenge we’ve been dealing with for many years, but COVID has really exacerbated it and brought it more into the spotlight because we know that the risk of a severe or very poor outcome with COVID is dramatically increased by having chronic conditions like diabetes, obesity, other types of heart or lung disease, etc. And it’s not just that chronic disease puts us at risk for a shortened lifespan and healthspan; it also puts us at greater risk for acute conditions, like SARS-CoV-2 and COVID-19 as a result. So this is really what Functional Medicine has to offer. It’s a much more holistic, patient-centered, collaborative approach, which shifts the focus away from just managing disease after it [has already] occurred to preventing disease, ideally, from developing in the first place. And if it [is] already starting to develop, intervening at a much earlier stage. It really seeks to deal directly with the underlying or root cause of a health problem rather than just suppressing symptoms with drugs.
One of my elevator speeches that I will sometimes use, and it depends on the context, of course, but there are lots of analogies we can use for Functional Medicine. One is [that] if you have a rock in your shoe and it’s making your foot hurt, you could take ibuprofen or something like that to deal with the pain. But it would be better to, first of all, recognize that there’s a rock in your shoe that’s causing the pain and, second of all, take off your shoe and dump out the rock. That’s really what Functional Medicine has to offer, and it’s the best way to resolve these long-term chronic problems.
Tracey O’Shea: I totally agree. I love that analogy. It’s always like, “Oh yeah, that makes a lot of sense.” Even though it seems like common sense, [there’s] still many, many years of tradition [in the] way that practitioners were trained, [and the] ways that patients were trained to accept medical advice. It’s still an uphill battle because it’s a system that has been established for a long time. So even though that makes total sense, it’s still sometimes a hard sell to patients and to practitioners. And you and a lot of other people within this community and leaders within the community have really put a lot of effort, energy, and passion into getting that message across. And it feels like we are making headway, but we still feel like there are opportunities like this to make sure we’re not stopping the drumbeat. And that’s what this opportunity is, I think.
What’s Wrong With the Conventional Healthcare System
Chris Kresser: Absolutely. So let’s talk a little bit about what’s missing in the current approach to healthcare. Obviously, we just touched on some of the main points. But one of the things that I highlighted in my second book, Unconventional Medicine, which is really much more about the topic of this show, is this concept of disease management. We talk about [our] healthcare system, but it really is more of a disease management system [in] the way it’s set up. Because it’s not doing much to promote health. It’s really there to manage disease or other problems that crop up. And if we just stop there, that’s a problem. Because if you are just waiting for disease to occur before you intervene, then you’re always behind the curve.
Tracey O’Shea: It’s already too late.
Chris Kresser: It’s too late. Yeah. Or it’s going to be way harder, right? So let’s just take type 2 diabetes as an example. We know that most people who develop pre-diabetes will go on to eventually develop full-fledged type 2 diabetes. Once they develop type 2 diabetes, it’s about a $14,000 to $15,000 per year cost to the healthcare system. It significantly erodes quality of life, [and] it can lead to really nasty complications like neuropathy, retinopathy, [and] even amputation of limbs. Obviously, it’s a serious disease. We know from research and also both of our clinical experiences that if somebody comes in to [see] us and they’ve got high normal blood sugar and we intervene at that point, it’s going to be far easier to return that person to a healthy metabolic state than it will be if they come to us when their A1C is already 9 or 10, and their fasting blood sugar is 160. That’s difficult. We can still make a ton of progress often with those patients, but the interventions have to be far more intensive. Sometimes medication will be required, especially if the capacity of the beta cells to produce insulin has dropped, [and] there [are] often significant other comorbidities that have to be addressed, and it’s just way harder.
Tracey O’Shea: I was going to say, [that’s] if endothelial damage hasn’t [already] happened, and vessel damage and organ [damage]. That’s the thing there is at every stage of disease, there are little bits and pieces that are likely irreversible and really difficult to go back and fix. So not only are you thriving and feeling better and having this wellness that you’re achieving, but you’re also, hopefully, preventing permanent damage to all these parts of your body that accumulate. And we have the capacity to do it; we actually have the technology and the knowledge and the information to be able to catch these diseases at these very early stages [and] to be able to intervene. But it’s just not common practice, and [that] just blows my mind. But that’s why we’re here. I’ll leave it at that.
Chris Kresser: I mentioned this example of diabetes in the book because I think it’s a really illustrative case where sometimes one of the critiques you will hear of Functional Medicine is that it’s too expensive. And I’m not talking about [critiques] from individual people, because I agree that, for individuals, it’s too expensive right now, and only a small percentage of people can access it [as] fee for service. That’s changing, I think, now and will continue to change. But what I mean by too expensive [is] complaints from within the medical establishment or complaints from people who are experts in public health [who] are looking at “is Functional Medicine a viable model for our system in the [United States]?” And they say it’s too expensive, [that] there [are] too many tests ordered upfront. I look at that, and I say that’s absurd. Because if we say it’s $15,000 a year to treat a patient with type 2 diabetes, [and] let’s say somebody’s diagnosed at age 40. One thing our medical system is really good at is keeping people alive for a long time, even if they’re not healthy and well. So someone with full-fledged type 2 diabetes might still live until they’re 80 [years old] at least. Let’s just say 80. That’s 40 years at $15,000 a year. That’s a lot of money, right? That’s $600,000 for just that condition for that one person. If the healthcare system adopted this [Functional Medicine] model and they had to spend, let’s say, $1,000 on upfront testing and treatment when that person has pre-diabetes or even high normal blood sugar, and we could prevent them from progressing to type 2 diabetes, which is totally possible, we do it all the time, that’s a savings of $599,000. I mean, I’ll take that as an investor. That’s a really good deal. And it’s totally possible if there is political will and infrastructure that can be created around this. And I think that will happen. It’s almost inevitable. Because what we’re seeing is that the current system is just completely buckling under the burden of chronic disease, and some estimates suggest that the healthcare system is going to bankrupt the government as early as the 2030s if significant changes aren’t made.
Tracey O’Shea: Yeah, I think that’s hard to ignore, and it’s a tough pill to swallow for other people who have been deep-set and accustomed to an older model. Change is hard for people, and it’s important for me to say [that] we’re not saying that this model just doesn’t work at all. It works great for acute issues, emergency room, [and] surgeons. I, for sure, want a really knowledgeable surgeon if something comes up and I’m in a motor vehicle accident. Those needs are there, and the current model does okay with that. But like you said, it’s this chronic disease epidemic that it just can’t keep up with. So we’re not saying it’s bad news altogether, and that the training that other practitioners have had is bad or inadequate, [but] it’s just not keeping up. The proposal here is to shift the way that we handle chronic illness by changing the framework and changing the model. I mean, that’s adapting, right? That makes sense.
Chris Kresser: We don’t need to leave. Conventional medicine has made absolutely almost miraculous achievements in so many different areas like restoring sight to the blind, being able to reattach limbs, [in] some of the innovations in terms of cancer treatment. It’s really just incredible. Like you said, we’re not suggesting we just abandon that and leave that behind. We can bring forward all those amazing innovations and also incorporate or have them exist side by side with a much more holistic, root-cause-based approach to treating chronic disease, which, again, going back to what I said in the introduction, is the biggest challenge that we face at this point from a healthcare perspective. So that’s the best of both worlds, where you put all of that together. We can have [a] much better quality of healthcare and still have all the amazing achievements and accomplishments of conventional medicine for [the] acute issues that we face.
Tracey O’Shea: I totally agree. And I think there [are] advantages on both sides. There [are] advantages to the practitioners and to the clinicians who are practicing, and then there [are] advantages to patients. It feels like a win-win for me.
I wonder if we should talk a little bit about how this change can impact both sides of the spectrum and why we need it and how to get there.
How Functional Medicine Provides Meaningful and Rewarding Work for Healthcare Practitioners
Chris Kresser: Big changes like this don’t happen overnight. There are [lots] of factors that make a move toward a more functional-based paradigm challenging within the medical model that we have now. And I don’t want to go too far down that rabbit hole. Obviously, financial interests are part of it, but it’s also just [that] you have a whole infrastructure and system that has been built around certain principles and ideas for 150 years, and that doesn’t just pivot overnight.
So I’m actually encouraged by some of the changes that we’re seeing. You’ve got Cleveland Clinic Center for Functional Medicine, you’ve got Functional Medicine being integrated into the models that a lot of new digital telehealth and at-home diagnostic and therapeutic tools are launching with, and I think Functional Medicine will just sort of gradually permeate the system and newer initiatives that are launched will have more of a Functional Medicine approach and base. And it’s not going to be a big noticeable [thing], [like] one day we wake up and there’s a news flash that now we’re using Functional Medicine instead of conventional [medicine]. That’s not how it’s going to work. It’s going to be a gradual process where this unfolds. But it does start with acknowledging what the problems are, and I think that’s already happened.
Everyone knows that the conventional model is not working. I don’t care whether you’re a patient, a practitioner, an allied health professional like a coach or nutritionist, whether you work for a health insurance company, [a] HMO, [or] you’re peripherally involved in the medical field in some way. Everybody. That is the one thing that is not controversial in all of this. I’ve never met someone who thinks that our current system is working flawlessly, or even very well at all. People can argue about the solution, but I think everyone is on the same page in terms of the problem. And I would say that doctors and practitioners themselves are the first people to realize that. I know, Tracey, [that] you were conventionally trained originally, and we both interacted with tons of conventional practitioners, both through our ADAPT Functional Medicine Practitioner Training Program and in the various jobs and positions that we’ve had. I’m curious to hear your take, but almost always, the providers I talk to totally understand the limitations of the system [and] are super frustrated by them. They just feel a little bit trapped, and don’t know what to do about it.
Tracey O’Shea: I agree. I think frustration and fatigue come to mind a lot when I’m speaking to a lot of other practitioners and clinicians, and also a little bit of fear because you’ve invested a lot of money into your training. People walk out of medical school, nurse practitioner school, whatever, with a pretty big bill next to their name. It’s always a little scary to make that shift knowing that you still need to support your family and to weigh those things. But I think at the end of the day, what comes out at the end is this need for fulfillment and this need to find a career path that resonates with them. I think that’s really what sticks out to me [on] the practitioner and clinician side is that they’re tired, they want to spend more time with the patient, and they want to feel like their patient is getting better.
That’s really a lot of what is driving the decisions for these practitioners to transition from this conventional model to a more Functional Medicine paradigm. Having the confidence to do that is the next step, and that’s where the training comes in, and [having] allies of other people [who] are practicing Functional Medicine, [and] starting to understand what role you can have in this movement. And then once you are part of the movement, you have this really robust community that continues to push and push and push and is really helping patients achieve their optimal health. That’s the primary goal. That’s what I have seen as practitioners have transitioned in their journey in their career from conventional to Functional Medicine practice.
Chris Kresser: Yeah, I’ve seen something similar. And I know that we’ve had podcasts before, and I’ve written articles about this, and I talked about it in the book that the rates of burnout among healthcare practitioners are just astronomical and growing every year. We have a pretty high percentage of doctors and other clinicians leaving the health field entirely. And this has been amplified during [the] COVID [pandemic], of course. There’s even a term for it now, “the great resignation,” [in] which I think a quarter of all medical providers left the field over the last couple of years with no intention to return. That is not good. We have a shortage of something like 40,000 primary care providers [who] are needed, and to have a quarter of all medical professionals leaving the field is exactly the wrong direction that we need to be moving in.
Tracey O’Shea: I don’t know the numbers, but if I had to guess, the COVID vaccine mandates, all these things, were the catalyst to something that was already deeply brewing. There’s probably a percentage of people that felt very strongly about some of those reasons and would have left either way. But I think having a baseline level of frustration and already being burned out, and then you add this extra layer of stress, [and it] is all they needed to make that the tipping point. So it’s not just this thing that has happened in the last two years; it is this thing that has been happening and is culminating and building. And now, here we are, seeing the results of that over many, many, many years of frustration.
Chris Kresser: I agree. So let’s talk a little bit about what is possible for practitioners and patients when we move to this model. One of the first things, and this I know [is] true for you, Tracey, [and] is true for me, [too], is you get better results as a practitioner. You actually are able to accomplish what most of us as clinicians set out to be able to accomplish, which is to help people truly be able to heal and get better instead of just managing their disease. And that is so rewarding and fulfilling, and it really is why I think most people go into medicine and healthcare because that’s the impact that they want to have on people’s lives. And it’s super frustrating not to have that impact, and that’s what leads to burnout.
It’s hard to even put that into words because it’s such a game changer. It’s the difference between getting up in the morning and being genuinely excited about going to your job [or] doing your work and just dreading it. Right?
Tracey O’Shea: I would be really interested if we had career satisfaction surveys that you’re doing on a daily basis. But 100 percent, you can feel the difference. Any practitioner has had those stretch[es] of days where you’re just like, “Geez, no one is saying that they feel better. No one is saying that their symptom score is getting any better.” That is deflating and depressing, to be quite honest. And that is the difference, at least for me. [What] has really shifted is this recognition of, “Oh, it’s just nice to hear that someone feels better,” and that there’s this general, nice, beautiful trend of less symptoms, improved health, and you don’t get that [in conventional practice]. I feel pretty grateful to even be part of that process. So 100 percent, I think that that’s a big piece of this.
Chris Kresser: It’s difficult to overstate that. It makes all the difference in the world. And if that was the only difference, it would be more than enough. I think another piece of it that’s crucial for me, and again, I think that it extends to most clinicians, is that Functional Medicine is an approach where you’re always learning, you’re always adding new tools, you’re always layering new things in that can further help patients, and it’s deeply satisfying in that way. Of course, that can be true if you’re a specialist in conventional medicine or even a primary care provider. That opportunity for continual learning is always there, as well. But I think it’s what you’re learning about and the potential impact that those things can have on your patients that make[s] it even more interesting and fascinating and engaging to be in the field of Functional Medicine. That’s certainly what I’ve found, and I have been fortunate to make a career out of that learning and research.
I know many other clinicians [who] are doing that in different ways, some just on their own, and it’s just for their own edification and ability to help their patients. But there are many Functional Medicine clinicians [who] have started their own online platforms and are doing group programs and building their own products or diagnostic or therapeutic solutions. And it’s really an exciting field with a lot of energy and enthusiasm behind it. And it’s really fun and engaging to be a part of that.
If you’re a licensed medical practitioner, taking a patient-focused, root-cause-based approach can produce dramatic improvements in your patients’ overall health. Tune in to this episode of Revolution Health Radio to learn more about the ADAPT Functional Medicine Practitioner Training Program and how it can help you turn the tide of chronic disease. #chriskresser #kresserinstitute
Tracey O’Shea: Yeah, there’s so much innovation, which to me is the remarkable part of this. I think as practitioners, we already have this drive for education and knowledge, but it [felt] next-level for me when I transitioned to Functional Medicine and started being around a community of like-minded practitioners. The amount of drive to learn, for me, [is] next-level. Every single Functional Medicine practitioner [who] I have contact with in my community is constantly learning something new and sharing and applying. It really blows my mind how much innovation and how much drive exists within this community of Functional Medicine practitioners.
Chris Kresser: It’s exciting. And of course, what also comes with this is more freedom and flexibility in how you work. You and I have been doing this in different ways. Right now, I think you’re seeing patients virtually mostly, and you were able to pivot to that quite easily when COVID hit. Whereas a lot of practitioners who were more stuck in a conventional model were not able to do that. And I think that was part of the great resignation and what happened there. Or maybe they switched to some kind of virtual model, but it wasn’t something they were prepared for and didn’t have systems set up [for], so it was really difficult.
Tracey O’Shea: Like a crash course.
Chris Kresser: I’ve always combined patient care with research, training, education, writing, and speaking, and the combination of things that I get to do on a day-to-day and week-to-week basis feels like an amazing balance and really keeps me interested in lots of different things and makes it less likely that I’ll get burned out by doing one particular thing only. And you can have a lower caseload. A lot of primary care doctors will be seeing 25, 30 patients a day and have a panel of 2,500 patients. In Functional Medicine, you would never get anywhere close to those numbers. You might do an initial appointment that for some practitioners might be a two-hour initial appointment, or it might be an hour, or it might be an hour and a half, and then your follow-ups are a half-hour instead of 10 minutes.
So you’re forming much deeper relationships with patients. You’re able to really listen to them and guide them, it just feels way less hectic. You don’t typically have to work as much to make the same amount of income, and you have more time for family and pursuing other interests. And for me, that was huge. Those quality of life pieces were really important. Especially as care providers, that’s important. We have to be able to take care of ourselves if we want to be able to show up and take care of other people. And I think, unfortunately, doctors really suffer from working insanely long hours, and then they go home and they’re still charting and, where’s the time to do research? Where’s the time to take care of themselves? Be with their families? It’s really, really a struggle for many doctors.
Tracey O’Shea: We’re having to relearn what this all looks like, and work ethic, and “Oh, if you don’t show up, [if] you’re not the first one in, last one out, then you don’t care about your job.” I mean, it’s just this entire movement and shift in the way that we know [how] to practice medicine. And that’s what I love about Functional Medicine and about the programs we have is [that] there’s still this lingering discussion every time about, “Yes, but what are you doing for yourself? Yes, but also, how can you manage to fit this in for yourself?” Because you have to show up for your patients just as much as you have to show up for yourself.
Chris Kresser: Absolutely. And for the patients, on the flip side of this, where we talked about one of the first benefits for practitioners [being] that you’re more effective, right? You actually are able to help patients and accomplish the goal, which is to maybe not just help them manage a condition but actually to completely eliminate that condition. They can heal from that entirely, or if they have pre-diabetes, they [can] go back to having normal blood sugar, or if they have [irritable bowel syndrome], [then] they don’t have it anymore. This is what’s possible. And obviously, the benefits to patients in that scenario are pretty obvious, right? Instead of spending a lifetime going to the doctor and taking medication, which often tends to increase over time, right? Because you take a medication and it might have side effects, and then you need another medication to manage those side effects. I’m sure a lot of listeners are familiar with how that goes. In the Functional Medicine model, there’s actually the opportunity for real resolution of these issues. Of course, that doesn’t always happen. But there’s the real possibility of that happening, which is different, again, in many cases than the conventional model.
Tracey O’Shea: And word spreads. I don’t know how many times I’ve had a patient feel better, and then they tell their family member, they tell their friends, and before you know it, I’ve got three new patients just because this one person is feeling better and they’re living, they’re thriving. And pretty soon, that patient now has a community of healthy people around them. It really is this movement that keeps expanding, expanding, expanding, and at the center is that increased connection, the additional time that you spend with them, and that genuine investment in their health. And they can see that, and they get better, as well. So it’s just remarkable to see.
Chris Kresser: It sure is, and my hope is that this is going to continue. It’s not even a hope. That’s kind of a silly thing to say, actually. I’m going to revise that. It is happening. We see it all over. I’m on the advisory board of several new companies that are in the telehealth space, the digital diagnostics and therapeutic space. You’ve got Parsley Health and SteadyMD and Salvo and Clearing and all these companies that are innovating within patient care and medicine. And they’re all using a Functional [Medicine] model, or at least a functionally informed model, to do what they’re doing. So that’s enormously exciting. And what it means is [that] there’s going to be more and more opportunities for Functional Medicine clinicians going forward. We’re just at the tip of the hockey stick here if you’re thinking about this as a chart.
Tracey O’Shea: Oh yeah, I feel all this energy just waiting to be disbursed. I agree, there’s a huge calling for that.
Chris Kresser: It might sound like it’s neither here nor there to some extent from the perspective of an individual clinician, but zooming out and looking at the [entire] market, there’s an enormous amount of money moving into Functional Medicine from venture capital and private equity. And that just tells me that Functional Medicine is set to really explode and go mainstream in a way that is just starting but hasn’t happened fully yet. So that’s going to be pretty incredible.
Tracey O’Shea: If the people with money start to care. It’s kind of one of those [things].
Chris Kresser: Well, it is. Or it’s that they are recognizing that this is a real thing. It’s happening; it’s a trend that is not going away. And in fact, it’s the future of healthcare. There’s the saying, “follow the money,” right? So if you see that really savvy, big investment firms are investing in this, it’s a sign that we’re reaching an inflection point and that Functional Medicine is really moving to a place where it’s no longer just a niche thing. It’s now moving mainstream and serving as the backbone or operating system of a lot of these new innovative healthcare initiatives.
Tracey O’Shea: It’s exciting. I’m excited. I’m personally invested in the movement of Functional Medicine because I’m so passionate about it, and I’m practicing. But also, as the director of our [Functional Medicine] Practitioner Training Program, I see all this opportunity just waiting to happen. We have so many people [who] have already gone through the program and people [who] are still very interested.
I think we should talk about the program because I’m dying to talk a little bit about what the opportunities [are] for people [who] think that they’re ready to make that transition and how to do that and what the program [is], in general.
The ADAPT Functional Medicine Practitioner Training Program
Chris Kresser: So a brief backstory here is, when I first started treating patients way back over a decade ago, I was so busy so quickly. Pretty much right after I graduated from school, my practice was full. And I realized that the demand for Functional Medicine providers far outstripped the supply. It wasn’t long after that that I decided to create the ADAPT Functional Medicine Practitioner Training Program because I saw that there was a huge demand for Functional Medicine clinicians that wasn’t currently being met. There [are] some other solid training programs out there, but none that actually provided people with the real clinical skills that they needed to treat patients in the program itself.
I’m a very practical person and a kinesthetic, a person [who] likes to learn through experience and actually doing things. And some of the existing programs were much more didactic in nature. What that means is they’re more academic. They provide a lot of great information on the theory of Functional Medicine and the background, the mechanics, etc. But they don’t actually prepare people for how they’re going to do it when they go to their office on Monday morning and see the patient. What tests are you going to order? How are you going to interpret those tests? What treatment are you going to prescribe on the basis of that? How are you going to set up your practice? What systems are you going to use to run it? All these things are really where the rubber meets the road, right? That’s really what determines how successful you will be or not be in your practice.
So, when I created the program, it was really [in] an attempt to answer the question, “What would I have wanted to learn?” I had to do it sort of Mr. Miyagi style. A little Karate Kid reference for those of you [who are not familiar with that].
Tracey O’Shea: Piecemealing all this stuff.
Chris Kresser: Exactly. Like [an] apprentice. I apprenticed with different practitioners, I learned through books, I went to workshops and seminars, I interned, [and] I pieced it together. And there’s something to be said for that. But it took a long time. And there were a lot of missteps and a lot of rabbit holes, and a lot of wasted time and energy and effort. So I came away from that experience thinking it’d be really cool if there was a 12-month program that taught you 80 percent of what you needed to know to have a successful practice right when you finish the program. And that was really the foundation of the ADAPT Functional Medicine Practitioner Training Program, which we launched back in 2016. We’ve trained over 600 clinicians in 28 countries around the world. So this is not just a U.S.-based thing. Functional Medicine works everywhere in the world. [Though] there [are] obviously some different considerations in different countries.
The feedback has been one of the most gratifying things that I’ve ever done in my career. When we go to conferences or run into people and hear from doctors and other practitioners who’ve been through the program, [hearing] the way that it’s transformed their practice and their lives, [that’s] what helps me [and] what gets me out of bed excited. One of the many things that get me out of bed excited in the morning is just knowing the impact that we’ve had there.
Tracey O’Shea: That and a good snow day, I hear.
Chris Kresser: That’s true. All part of a balanced life.
Tracey O’Shea: Yeah, exactly.
Chris Kresser: That goes back to what we were talking about in terms of flexibility. I can go out and go skiing for an hour or two a few days a week because I’m not in a grind for 50 or 60 hours a week doing only patient care.
Tracey O’Shea: My personal experience [is that] I had gone through [another] program before going through the ADAPT Practitioner Program and before you and I started working together, and they kept saying, “Well, you’re going to be able to start, you’re gonna be able to walk into your office and know exactly what to do on Monday.” And I kept going, “Am I missing something? Because I really genuinely do not know what to do on Monday.” I [understood] the concept of all this, but I [didn’t] have any tangible instructions, any tangible information on actually what to do. Once I took the ADAPT Functional Medicine [Practitioner] Training [Program], I was like, “Oh, okay, okay, okay.” This starts to make a lot more sense. There’s a framework. I know exactly how to approach a patient; I know exactly what labs to order. And then the most important part is what to do after that lab [results come] in. I don’t know how many patients have brought lab results to me from other doctors, or [their doctor] agreed to run this lab, but they don’t know what to do about it. They don’t know what to do with that lab result. And so they just said, “Here you go. I’m sorry, [but] I don’t know how to interpret this.” And they end up back at my office eventually because they have five different labs that no one knows what to do with. And that’s really the framework, I think, that the ADAPT program provides. And that’s the feedback that I’ve gotten from practitioners.
It’s like, “I know exactly what to do. I know exactly what to order.” And you have this community of ongoing graduate support and other fellow alumni that you can also poll, and you can ask them, “Who else has experienced this? Who else has seen this? I have this case that I’m having trouble with. What should I do about it?” So you have this group and community of people that are just as passionate as you and have had the exact same framework and education as you, and you all get to be this investigative community together. And that’s really what’s fun and what has been nice to watch and see. That’s what I like.
Chris Kresser: That’s a really critical part of it. And I think there [are] some other aspects that are probably worth pointing out. Like [that] the program is built around what works and what gets the best results. So it’s not dogmatic. It’s really what I [have] learned from 15 years of practice and then [what] you and many other people [have] contributed to the program collectively. We’re talking about 50 years of collective clinical experience. People who’ve followed my work for any length of time know that I’m very research- and evidence-based, but I’m also very practical and non-dogmatic. I don’t get hung up on one particular theory or idea. I’m more interested in what can actually help patients. And that translates into what tests we teach in the course, what protocols we teach, and we actually tell you the tests, the name[s] of the tests. How to order them, how to interpret them, what actual supplements we use. And other programs don’t do this because, [and] this is an important thing to note.
Tracey O’Shea: I was going to say it’s a really important thing to note.
Chris Kresser: We don’t provide continuing education credits, CME. This has been a very intentional choice because as soon as you do that, you can no longer talk about specific tests, specific products, supplements, [and] treatments. That actually makes you disqualified from being able to provide CME. We’ve often gotten questions over the years from people about why [we] don’t provide CME. This is why. It’s not an omission. It’s not a bug. It’s a feature. Because it’s really what turns this program more into a residency or an internship rather than medical school. We’re actually telling our students exactly what we do. And the idea there is not that they necessarily do exactly what we do. But it’s like when you learn an instrument, you’ve got to start with the scales, right? Or, if you learn a martial art, you start with the kata or the forms. And then, over time, as you get better, you make it your own. But it’s really hard to learn an instrument without practicing those scales, and it’s hard to learn martial arts without learning those basic forms, right? So that’s the difference between our program and many other programs.
Tracey O’Shea: And you’re learning it from people who have done the exact same thing, who started at the basics and then evolved and adapted their practice. And what’s nice is [that] I’m constantly updating the program to reflect what we are actually doing in practice. What’s working, what’s not working. That’s what’s nice about us actually practicing medicine and then being able to bring that information into the program. It’s up to date. This is actually what I’m doing on a daily basis in my practice. I think that’s really important to stay up to date with what we’re doing.
Chris Kresser: For sure, yeah. We don’t have a textbook that was printed in 1978 that we need to update. That is an advantage of these kinds of online curricula because we can update [them] on the fly, and we do [that] very often.
Tracey O’Shea: Right. I was going to say real quick[ly] that the course also offers certification, and it’s important for practitioners to have recognition [for] completing this 12-month course. It’s full of weekly lessons, quizzes, [and] live Q&As where you’re able to speak to faculty, [and you can] ask and answer questions throughout the course. Then we also [build] this framework. You get patient handouts that you’re able to brand with your practice logo. There [are] over 50 of those, so you don’t have to do the work. That’s the whole point, to be able to use that structure. Then we also have clinician handouts, which are quick, to the point, key takeaway, review handouts that you could go back and be like, “What was it that they said about this one thing?” You can just go back and check that clinician handout.
Then we have the other pieces that we talked about, like nutrition lifestyle training. [The] practice management course, which is kind of a big piece of this, is “How do I start my own practice? Where do I even begin? How do I run a Functional Medicine practice?” There’s a whole course dedicated to this turnkey practice management system that you’ll learn. And we also have a really great marketing course. It’s a bonus course. It’s a $4,000 value [and lasts] 12 weeks. You can use it at any time, and it teaches you how to market yourself in this community, how to market yourself to patients to get good patients [who] are here, are dedicated, [and] want to show up for you and for this practice. And also how to make yourself hireable in this community. So it’s just fun. I think there’s a lot of stuff.
We are also, like I said, offering certifications. By completing this course and the quizzes and the final exam, you’ll be able to call yourself a Certified Functional Medicine Practitioner and tell people about it. Yell it from the rooftops.
Chris Kresser: Absolutely. So we have an enrollment that’s coming up here.
Tracey O’Shea: [Enrollment opens on] September 23rd, and [will last] for about two and a half weeks, [from] September 23rd through October 15th. That cohort is scheduled to start on October 15th, and it’s [a] 12-month course, so it’ll be [from] October 2022 to October 2023. [Chris and I] are going to have an informative Q&A session on October 4th at 1:00 p.m. Pacific Time. We’ll be answering any questions that you have about the program, [like] is it the right program for you? Is [it] the right time? Anything you need, we are there to answer. We’ll also [have] that registration link on the practitioner page. You can log on [and] join us. We’ll answer questions for you. There may [also] be a discount code that you can use when you enroll in the program. Chris, do you want to tell them the link where people can go and find more information?
Chris Kresser: To find more info, sign up for that [live] session, [or] just learn more about the program, it’s kresser.co/practitioner. Thank you, Tracey, for joining me. I hope those of you who are newer to Functional Medicine got a lot out of this, practitioners, healthcare professionals, and just individuals looking to improve their health. And if you are an individual looking for someone to work with, as I said, we’ve trained over 600 practitioners around the world. If you go to kresserinstitute.com, you can click on “Find a Provider”’ and you can look for somebody we’ve trained [who] might be in your area. Or also, a growing number of clinicians are working virtually now. That is one of the side effects, if you will, of COVID. It really opened that [up] as a possibility in places that [maybe] wasn’t available before.
So thank you, everybody, for listening to this [episode]. Thank you, Tracey. Keep sending your questions in to ChrisKresser.com/podcastquestion, and we’ll see you next time.
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