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physicians learning the latest
drug protocols and approved
formularies for treating the
increasing epidemic of obesi-
ty, heart disease and diabe-
For thousands of years herbal
and nutritional supplements
have been an integral part of
Despite what the television
commercials and lobbying
pressure from big pharma-
ceutical companies would
suggest, there is an abun-
dance of evidence based re-
search and experience show-
ing the safety and efficacy of
many natural treatments.
We have a much larger ¡°tool-
box¡± of treatment options
than the local pharmacy can
Along the same lines, a
lengthy list of complementary
therapies such as chiropractic,
acupuncture and massage
have proven benefits.
Stress management tech-
niques including meditation
and biofeedback lower blood
pressure and blood sugar.
Yoga and dance expand the
traditional ideas of exercise.
The point is that physicians
don¡¯t have all of the answers
and integrating other health
practitioners is part of the
2019 August/September
Pg 6 - The Sunshine Express
Health & Nurturing
fication of Diseases or ICD.
Version 9 is about to be replaced by version 10
and goes from 13,000 to 68,000 possible codes.
If a physician wants to get paid via insurance they
must submit the proper codes.
ICD coding is useful for the government and the
insurance companies to facilitate billing, assess
data and measure outcomes, but is one of the big-
gest detriments to healthcare today.
The entire system revolves around codifying and
classifying of patients according to the disease or
illness they have. This reductionist mentality trains
and rewards physicians to see patients through
the lens of a disease label instead of a complex
and unique person.
The ancient healing arts emphasize restoring har-
mony and balance to the patient¡¯s underlying body
Ironically, modern research combined with tech-
nology is enlightening us, and reminding us, of
this principle. From genetics to the microbiome
we are making huge strides in understanding
how specific disturbances in core systems lead to
Focus on healing underlying systems is the core of
While it doesn¡¯t always work this way, I think it
underscores the need to listen more and to un-
derstand what patients are up to and up against,
outside the office.
To truly heal patients we need to think holistical-
ly and we need the time to consider the mind as
well as the body. Addressing attitudes, spiritual-
ity, social networks, and stressors should be part
of the workup.
For our part as physicians, the intention to heal
and sincerity are powerful tools as well.
Almost one hundred years ago Harvard physi-
cian Francis Peabody wrote, ¡°One of the essen-
tial qualities of the clinician is interest in human-
ity, for the secret of the care of the patient is in
caring for the patient.¡±
Perhaps now more then ever this is needed in
healthcare, for the sake of the patient and the
Areas such as nutrition and exercise get little
more attention than a feel good marketing mes-
sage in our current ¡°sickcare¡± model.
Having health coaches, nutritionists and per-
sonal exercise trainers involved in every primary
care clinic would likely do more good than
Exploring the Parallel Universe of
Functional Medicine
There are two worlds of medicine today, the
conventional disease-centered model and the
patient-centered model that treats each per-
son as a unique entity with diverse systems
of genetic, biologic, social and environmental
As a board certified, teaching physician, I
know the conventional system well, but as a
¡°functional¡± medicine practitioner I feel like I
am living in a medical parallel universe.
For over one hundred years ¡°modern¡± medi-
cine has taught doctors to identify and treat
disease. We learn the skills that lead us to a
single diagnosis amongst all the different pos-
The patient is then labeled as having this or
that disease and for every disease there is an
approved code, called the International Classi-
functional medicine. Instead of simply
putting our patient into a disease clas-
sification, we strive to uncover the origin
of symptoms or disease so that we might
eliminate the issue altogether.
Advanced testing allows us to gather
information unheard of just a few years
ago, such as genetic mutations, nutri-
ent or hormone deficiencies, metabolic
or immune disturbances, gut dysfunction
and food allergies, toxin accumulations,
chronic infections and more.
This information is invaluable in sorting
out root cause, yet so much of it is con-
sidered unnecessary or experimental and
outside covered insurance benefits.
More Than Just Testing
Including and engaging the patient in
the healing process is another aspect of
medicine that is lacking.
In the rushed world of conventional
practice we hardly have time to hear the
patient¡¯s story - there¡¯s no ICD code for
Everyone has a story, and listening to
that story is one of the most important
and rewarding processes in human inter-
action, especially so in medicine. It sets
the stage for healing.
I teach my students that 80% of diag-
noses can be gleaned from the patient¡¯s
history. The physical exam and lab tests
are meant to confirm the diagnosis.
In Harmony
by Scott Rollins, M.D.