You've finally found the healthcare provider you've been searching for. For years you've dealt with struggle, as you've been in and out of the doctor's office with your digestive complaints, only to be told, "We can't find anything wrong with you; it's probably IBS." Alas! You found a Functional/Natural Practitioner specializing in IBS and have an appointment! Your first appointment was excellent. You talked with them for over an hour, got some tremendous dietary and supplement regimens, and you're ready to get a handle on your IBS.
Only one thing, that initial appointment costs you $300, all paid out-of-pocket. Insurance wouldn't cover it, nor would it cover the $80 worth of supplements you purchased or the $200 worth of lab testing. Why does functional/natural/alternative care seem 'expensive'? Are there more cost-effective ways that can still get the job done?
1. Unnecessary Testing
Stool testing, breath testing, advanced cardiac testing, and over 100 blood markers could all be tested when visiting a Functional Medicine Practitioner. That seems excessive. Don't get me wrong; some people have chronic, complex conditions that may require more advanced testing. I'd say that's the exception, not the rule.
Let's take, for example, Irritable Bowel Syndrome (IBS). IBS is currently diagnosed using the Rome IV Criteria, utilizing symptoms of abdominal discomfort and a change in bowel habits over the previous three months. But really, IBS is more a "diagnosis of exclusion," meaning other, more severe conditions (Inflammatory Bowel Disease, Bowel Cancer, and Celiac) are first ruled out before considering IBS. In the conventional healthcare model, individuals may have had a colonoscopy, endoscopy, and basic stool testing. Most of which may come back normal, and you'll be told you probably have IBS.
In the Functional Medicine world, you may undergo food sensitivity and stool testing that shows some excellent data, but not for cheap. A new blood test called an IBS-Smart Test has shown some promise for diagnosing IBS. As we'll touch on later, several more affordable alternatives to testing have demonstrated good clinical outcomes with IBS.
2. Too Many Supplements
It's not uncommon for a patient to leave a practitioner's office feeling like they just bought an entire vitamin shop: Vitamin D for autoimmunity, Magnesium for constipation, Turmeric for inflammation, Resveratrol for anti-aging, ketones to help burn fat, Ashwagandha for stress, Probiotics for gut health, etc.
Any of those supplements has its place, but when you throw the kitchen sink at someone (and they spend more than they would on a kitchen sink), you don't know what helps and doesn't.
If only 1/7 of those supplements had helped, we could have saved our patients hundreds of dollars.
It should be our goal as practitioners to deliver the most amount of good to our patients at the least amount of cost. That speaks to the idea of healthcare value. Healthcare value can be defined as the quality of the care you receive divided by the cost of that care. As discussed later, cost-effective and highly efficacious functional medicine can be delivered with proper due diligence.
