FUNCTIONAL MEDICINE CONSULTATION

Functional medicine consultation- ideal for the patient who has one or more chronic conditions that perhaps are not responding as desired to current treatments, as well as for a patient just seeking a global health assessment. Most patients are established with a primary care physician elsewhere through their insurance and may also have one or more specialists through their insurance as well. My goal is to work in tandem with your existing healthcare team to come up with a comprehensive health plan for you.


For more information about Functional Medicine Consultations and how to determine if one might be a good investment for you or a family member Click HERE ( Functional Medicine FAQ)

First, We go through your homework! Prior to this visit you will have completed an in depth health history questionnaire along with a current medical symptom review and a 3 day food journal. You will also have compiled any lab tests, scans and treatment plans performed in the last 2 years or that you feel are relevant to your current concerns. Based on this information, we will come up with a timeline of your health journey similar to the format I presented to you on my “About Me” page. Our next steps will be to establish our mutual goals for your health. We will discuss your answer the question- “what does optimal health look like for me?” and in doing so we will prioritize our treatment targets based on the body systems that may be out of balance. I we will discuss if certain lab assessments or lifestyle trials may give us more information on root causes. We will discuss certain supplements that may be beneficial and come up with an initial action plan.

These visits are scheduled for 90 minutes.

At any follow up visit we will review the results of new labs that may have been ordered and the  progress of our initial plan. 

We review these questions every time:

  1. What is better?
  2. What, if anything, is unchanged or worse?
  3. What information do we have now that we didn’t before (ie lab results, etc.)?
  4. Do we need to make any changes to our action plan to work towards our goals?
  5. What is a reasonable timeline to expect improvement and when should we re-evaluate?

 

Follow up visits are scheduled for 30 minutes.

Subsequent follow-up visits are scheduled on an individualized basis depending on the needs of each patient. Typical intervals vary between 3-12 weeks depending on how many different goals we are trying to accomplish. Often we need to address one goal at a time so more frequent visits may be necessary for a while until everything has been covered.

I wasn’t joking when I said a large part of the initial visit is reviewing your homework. Prior to your first appointment you will be asked to gather a lot of information and do some extensive documentation on yourself. This includes:

  1. an in-depth family health history including parents, grandparents, and siblings
  2. a detailed account of events and the environment of your childhood
  3. a lifelong health history including reflecting on when you felt healthy and when you felt sick
  4. Significant emotional, physical, and social events in your life (trauma, losses, accidents, illnesses, etc)
  5. A current assessment of your social life- your stressors, your joys, your support network, your hobbies and activities. 
  6. A current assessment of your symptoms- to what degree have certain symptoms impacted you over the last 2 weeks, 2 months, 12 months? 
  7. A list of what has been done so far in terms of treatments or trials to address your current symptoms: medications, including when tried and side effects; herbs or supplements; surgeries or other procedures; alternative treatment modalities 
  8. A 3-day journal of your current lifestyle habits- this is a 3 day snapshot of what you ate and drank, how you slept, how you felt, and any physical or social activities you engaged in. 

 

In addition to this packet I will ask you to gather any health records from other doctors or health providers in the last 2 years, including labs and imaging as well as any other older notes or studies that you feel may still be relevant to how you are currently feeling. I will also ask you to gather and bring in all of the medication, herb and supplement bottles you are currently or recently using so we can make sure everyone is on the same page. 

 

While I understand this may seem daunting and burdensome to most of you, I promise it will be well worth your time investment.  Doing this inventory is often an eye opening experience for everyone.

Dr. Marina Rasnow-Hill

Services

What is Functional Medicine?

Functional Medicine is a paradigm that takes a systems biology approach to health and disease. Let us use a common ailment such as acid reflux to demonstrate the difference between a conventional and Functional Medicine framework. Conventional medicine would describe acid reflux as an overproduction of acid in the stomach and possibly prescribe a medication to reduce the symptoms of the disease by suppressing the body’s production of stomach acid. This treatment often provides relief, and in severe cases, short term acid suppression may be necessary. Functional medicine, however, would first seek the root cause of the acid reflux . It would view all of the biological systems working together in the GI tract and consider the presence of the symptoms of acid reflux as evidence of an imbalance of these essential biological processes. So instead of considering disease as a problem with an organ or organ system (i.e. acid reflux is a problem with too much acid in the stomach), Functional Medicine addresses the disease from the root cause, and looks for the imbalances in the biological systems (ie the reflux may be caused by an overactive defense mechanism resulting from unhealthy gut flora and/or food sensitivities). Functional Medicine operates in conjunction with conventional medicine, applying a more holistic framework of scientific knowledge about how the body works. Functional Medicine uses this knowledge to focus on reversing and preventing the root cause of diseases rather than masking or controlling the symptoms with a pharmaceutical based approach

What can I expect at my initial consultation visit?

First, we go through your patient intake packet that was provided to you when you scheduled your visit. This packet includes an in-depth health history questionnaire along with a current medical symptom inventory, as well as a 3-day food journal. You will also have compiled any lab tests, scans and treatment plans performed in the last 2 years, or that you feel are relevant to your current concerns. Based on this information, we will come up with a timeline of your health. Our next step will be to establish mutual goals for your health. We will discuss how you answer answer the question, “What does optimal health look like for me?” In doing so we will prioritize treatment targets based on the body systems that may be out of balance. We will discuss if certain lab assessments or lifestyle trials may give us more information on possible root causes. We will discuss certain supplements that may be beneficial and develop an initial action plan. Since there is a lot of information to cover, the initial visit is scheduled for 90 minutes.

How is a Functional Medicine visit different from a regular office visit with a primary care doctor?

Consider functional medicine like a consultation with a specialist. We are specializing in a systems biology approach and looking at your total health and well-being with a specific type of lens. Primary care visits are predominately conventional medicine based, for example, managing one’s hypertension, diabetes, or reviewing screening tests. These services may be reimbursed by your insurance and are included in what is generally classified as a standard office visit. These are important and necessary services and should be completed at regular intervals by your primary care physician. A Functional Medicine visit is far more detailed and involves greater time with the physician than insurance companies will generally reimburse. For this reason, additional fees for Functional Medicine consultations are charged directly to the patient.