Functional medicine is a systems biology-- based approach that focuses on determining and addressing the source of disease. Each symptom or differential diagnosis might be one of several contributing to an individual's illness.
A diagnosis can be the result of more than one cause. For example, depression can be caused by many different factors, including inflammation. Similarly, a cause such as inflammation might lead to a variety of different diagnoses, including depression. The exact manifestation of each cause depends on the individual's genetics, environment, and lifestyle, and only treatments that address the right cause will have lasting benefit beyond symptom suppression.
The functional medicine model evolved from the understandings and perspectives of a small group of prominent thought leaders that realized the importance of an individualized approach to illness causes based on the evolving research in nutritional science, genomics, as well as epigenetics. These thought leaders discovered ways to apply these new advancements in the clinic to address root causes using low-risk treatments that adjust molecular and cellular systems to reverse these drivers of illness.
These functional medicine thought leaders were able to apply new research in a way that frequently brought remarkable results to patients that had previously received unsuccessful treatments. Part of this advancement was a return to scientific concepts of discovering new ways to look for unifying factors at the cellular and systems levels that underlie organism-wide issues.
As others became interested in learning functional medicine, it became essential to systematize the approach so that it could be taught to a wider group of practitioners of differing backgrounds. The IFM approach to applying functional medicine is primarily practiced through a set of tools that defines both history-taking and mapping symptoms to the categories of root processes that underlie disease. Three of these tools are the functional medicine Matrix, Timeline, and the GOTOIT framework.
The functional medicine Matrix helps the clinician in organizing and prioritizing each individual's health problems as elicited by a detailed personal, family, social, and medical history. The Matrix is similar to a web decoder-- it organizes what seems to be disparate issues into a complete story to help the clinician gain a comprehensive perspective of the individual and therefore promote discussion of complex, chronic disease with the individual.
All clinicians take patient history, but what makes the functional medicine Timeline different is that it has the effect of offering the patient insight into previous life events to motivate them to change and participate in treatment. As an intake tool for organizing the patient's history chronologically, the functional medicine Timeline is a visual representation that allows clinicians to determine factors that predispose, provoke, and contribute to pathological changes and dysfunctional responses in the individual. In this way, practitioners will be able to observe temporal relationships among events, which can reveal cause-effect relationships that might otherwise go unnoticed. By covering the period from preconception to the present, the Timeline reflects the link between the entire lifespan and one's current health.
"GOTOIT" is a basic framework practitioners can use to discover the origin of each patient's disorder and therefore use personalized treatments that address specific causes. Standing for "Gather, Organize, Tell, Order, Initiate, and Track," GOTOIT is a teaching device to help practitioners complete the Matrix and Timeline. Using the GOTOIT framework can help providers establish rapport with their patients, identify unhealthy patterns, get to the source of their problem, and propose suitable, individualized treatments and lifestyle adjustments.
