Functional medicine is becoming increasingly popular in modern medical practice. Many doctors in Western countries are changing the way they practice by focusing on the root cause of the disease instead of just treating the symptoms.
Functional medicine shifts the focus from symptoms to the underlying factors causing the disease including genetics, environment, and lifestyle choices by establishing treatments that have the long-term view in perspective.
We take a closer look in an exclusive interview with Dr. Tim Trodd Specialist in Family Medicine at OT&P Healthcare based in Hong Kong.
Tell us about your education and your practice in Hong Kong, when did you integrate functional medicine and why?
I qualified from London University in 1980 and completed my General / Family Practice training in Oxford. Originally I came to Hong Kong on holiday in 1987 but found a post at the Ruttonjee Sanatorium when it was still a Tuberculosis Hospital. I did not imagine that I would still be here 31 years later!
At that time there was no nutritional training in our medical course or postgraduate General Practice course. I believe this will change. In the past 2 years a module in Nutritional and Environmental Medicine (Functional Medicine is called Nutritional and Environmental Medicine in Australia) has been added to Australian GP training. Hopefully this will become the norm.
In 1999 a family member became unwell and despite consulting many doctors we were unable to get to the bottom of the problem. A friend suggested that Functional Medicine (FM) may be helpful and as I was desperate I flew to an FM conference in Tucson Arizona 2 weeks later. This turned out to provide the answer and I changed my practice to incorporate Functional Medicine. I undertook formal training and passed my Fellowship of the Australasian College of Nutritional and Environmental exam in 2005.
What is functional medicine, and what is your philosophy behind functional medicine as it relates to your practice?
Functional Medicine to me is about helping an individual to function as near to their individual potential as possible, whether they are a child with developmental delay, an adult with fatigue or a seemingly healthy person living in a modern environment. I found it stimulating to incorporate FM methods in to my everyday practice. In general FM requires a partnership with the patient, after all they may be changing their diet and lifestyle over a long period of time and nutritional deficiencies usually take 3 to 6 months to correct.
There will be a shift in this direction over the coming years and decades. Big data analysis, gene testing, environmental change, personal devices such as Fitbits and Apple watches, increased longevity and consumer pressure will drive medicine this way. Health will become a life long project to get the best outcomes rather than just treating episodes of disease as they occur.
Can you elaborate on your perspective as to why functional medicine is controversial particularly in Western Medicine, why is there so much resistance?
I do not think that FM is particularly controversial in Hong Kong, rather it is not recognized. Medical education uses a traditional model, which does not include many of the elements of FM, and much of the postgraduate advanced continuing education is sponsored by pharmaceutical companies.
Unfortunately there is no organization in Hong Kong such as the IFM in the US or ACNEM in Australia to promote FM. This results in lower awareness amongst the medical profession.
In Hong Kong there are several Naturopaths using FM techniques with good results. This does tend to result in FM and particularly nutrition not being seen as a bona fide medical area.
In regard to your practice how do you implement functional medicine?
In my practice I treat mostly children with developmental delays and the next group are adults with fatigue. However FM can be helpful in many illnesses including allergies, fatigue, irritable bowel syndrome, hormone imbalances, memory problems and cancer and my patient base reflects that.
In general an FM practitioner starts by treating the gastrointestinal tract and finding the correct diet. The next thing is to correct any nutritional deficiencies that have been identified by testing, unfortunately it is often not possible to get enough micronutrients even from the best modern diet. Then we move on to identifying more specific problems.
At what point do you recommend seeing a doctor specialized in functional medicine?
Health is a lifelong project, which may extend to 100 years or more. Maintaining optimal function and health starts in childhood. A healthy diet, healthy body weight and regular exercise are key. I think that regular nutritional testing beyond iron, gene testing and health monitoring will become the norm. However, we have to remember that only a small number of patients choose to seek a Functional Medicine opinion at the moment.
I would recommend that any person seeking a healthcare provider in Hong Kong carries out some basic research beforehand and this includes Functional Medicine. It is becoming increasingly common for clinics in Hong Kong to offer a broader range of services including allied health practitioners who use FM techniques such as Naturopaths.
What is the future of Functional Medicine in Hong Kong?
In my experience Functional Medicine resonates very well with patients. They want to become healthier and correct the underlying cause of illness rather than only treating symptoms. People want to live healthy as well as long lives and to be active and productive well in to late life. The only way to achieve this is by taking a proactive attitude to health. I believe that change will come and that change will be driven primarily by consumers.
I can also see a role for employers, insurance companies and governments.