Find out more about topics related to IFM's 5-day foundational course, Applying Functional Medicine in Clinical Practice:
Solutions to Address Compliance Issues
As administrative demands on doctors increase, direct patient care decreases,1 which often results in “most care in daily life [being] self care.”2 For example, when patients with diabetes spend only three hours on average with a healthcare professional each year,2 a heavy burden is placed on patients to self-manage their chronic disease, especially the details of the necessary lifestyle changes.
Patient non-compliance is a worldwide problem. In early 2017, Pakistani researchers reported a non-compliance rate of 68.8%.3 This figure is congruent with World Health Organization figures stating that developed countries typically have 50% non-compliance while developing countries have rates that are a bit higher.4 In the Pakistani study, less than a third of the patients complied with recommended preventative measures and lifestyle changes.3 As a result, the researchers proposed patient non-compliance as a hidden risk factor for disease.3
Part of increasing patient compliance is accounting for different goals and philosophies among patients. Some patients see themselves as the primary leader in their health care, while others take a more passive approach.5 Research shows that providers who approach patients as a partner with unique goals and priorities will empower them to self-manage their disease in a better way.6
In the following video, Monique Class, MS, APRN, BC, describes the tools that IFM provides to help patients make changes at their own pace:
IFM’s Applying Functional Medicine in Clinical Practice (AFMCP) teaches you methods and provides resources to address patient non-compliance, including a toolkit with hundreds of simple tools that guide patients through the difficult but necessary lifestyle treatments that allow them to successfully self-manage their disease. References
- Block L, Habicht R, Wu AW, et al. In the wake of the 2003 and 2011 duty hours regulations, how do internal medicine interns spend their time? J Gen Intern Med. 2013;28(8):1042-47. doi: 10.1007/s11606-013-2376-6.
- United Kingdom Department of Health. Self Care – A Real Choice. London: DH Publications; 2005. http://webarchive.nationalarchives.gov.uk/20130107105354/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4101702.pdf.
- Memon KN, Shaikh NZ, Soomro RA, Shaikh SR, Khwaja AM. Non-compliance to doctors’ advices among patients suffering from various diseases: patients’ perspectives: a neglected issue. J Med. 2017;18(1):10-14. doi: 10.3329/jom.v18i1.31170.
- World Health Organization. Adherence to Long-Term Therapies: Evidence for Action. Switzerland: World Health Organization; 2003. http://www.who.int/chp/knowledge/publications/adherence_report/en/.
- Randall S, Neubeck L. What’s in a name? Concordance is better than adherence for promoting partnership and self-management of chronic disease. Aust J Prim Health. 2016;22(3):181-84. doi: 10.1071/PY15140.
- Lawn S, Delaney T, Sweet L, Battersby M, Skinner TC. Control in chronic condition self-care management: how it occurs in the health worker-client relationship and implications for client empowerment. J Adv Nurs. 2014;70(2):383-94. doi: 10.1111/jan.12203.
Identify Metabolic Syndrome Faster
Due to the rise of obesity around the world, metabolic syndrome is now considered a “global pandemic,” according to researchers.1
In the United States alone, metabolic syndrome increased 28% over just one year at the turn of the 21st century.1
Appearing in 34% of the U.S. population, metabolic syndrome is the leading cause of death in the country and is especially problematic in certain racial and ethnic groups.2,3
Of course, patients with metabolic syndrome are also five times more likely to develop diabetes.4
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Preventing metabolic syndrome and the subsequent risk is best accomplished through early intervention. Before even ordering lab tests, screening for metabolic syndrome can be as simple as conducting a brief physical exam for visceral adiposity and acanthosis nigricans.5,6,7
Specifically, a simple waist-to-hip ratio may indicate increased risk for diabetes, heart disease, and other complications.8,9
IFM’s Applying Functional Medicine in Clinical Practice
(AFMCP) program provides a framework for integrating the patient’s history, physical exam findings, genetics, and lifestyle into an effective, individualized treatment plan that addresses the causes of metabolic dysfunction. Join your colleagues for this week-long introduction to Functional Medicine to learn about the emerging diagnostics, therapeutics, and prevention strategies that can help improve chronic disease outcomes and give your patients a more hopeful future. References
- Kelli HM, Kassas I, Lattouf OM. Cardio metabolic syndrome: a global epidemic. J Diabetes Metab. 2015;6(3):1-14. doi: 10.4172/2155-6156.1000513.
- Heron M. Deaths: leading causes for 2008. Natl Vital Stat Rep. 2012;60(6):1-95. https://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_06.pdf.
- Ford ES, Li C, Zhao G. Prevalence and correlates of metabolic syndrome based on a harmonious definition among adults in the US. J Diabetes. 2010;2(3):180-93. doi: 10.1111/j.1753-0407.2010.00078.x.
- Wilson PW, D'Agostino RB, Parise H, Sullivan L, Meigs JB. Metabolic syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus. Circulation. 2005;112(20):3066-72. doi: 10.1161/CIRCULATIONAHA.105.539528.
- Shuster A, Patlas M, Pinthus JH, Mourtzakis M. The clinical importance of visceral adiposity: a critical review of methods for visceral adipose tissue analysis. Br J Radiol. 2012;85(1009):1-10. doi: 10.1259/bjr/38447238.
- Hurt L, Pinto CD, Watson J, Grant M, Gielner J; CDC. Diagnosis and screening for obesity-related conditions among children and teens receiving Medicaid — Maryland, 2005–2010. MMWR Morb Mortal Wkly Rep. 2014;63(14):305-08. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6314a2.htm.
- Hesse MB, Young G, Murray RD. Evaluating health risk using a continuous metabolic syndrome score in obese children. J Pediatr Endocrinol Metab. 2016;29(4):451-58. doi: 10.1515/jpem-2015-0271.
- Löffler-Wirth H, Willscher E, Ahnert P, et al. Novel anthropometry based on 3D-bodyscans applied to a large population based cohort. PLoS One. 2016;11(7):1-20. doi: 10.1371/journal.pone.0159887.
- Mayo Clinic. Apple and pear body shapes. http://www.mayoclinic.org/diseases-conditions/metabolic-syndrome/multimedia/apple-and-pear-body-shapes/img-20006114. Accessed February 24, 2017.
Functional Medicine Strategies for Migraines
In the following video, Robert Rountree, MD
, offers a clinical strategy for a common clinical complaint: migraines.1,2,3
He explains how to use lifestyle and nutrition to relieve migraine symptoms and address their underlying causes. At IFM’s Applying Functional Medicine in Clinical Practice
(AFMCP), our educators will teach you strategies to find the underlying causes of this common complaint and many others.
Learn more about Functional Medicine strategies to treat various hormonal, gastrointestinal, and cardiometabolic conditions at our next AFMCP
. Using a case-based, collaborative format, AFMCP provides the tools you need to build upon your current clinical skills and improve your outcomes with all types of chronic conditions. References
- Lipton RB, Bigal ME. Ten lessons on the epidemiology of migraine. Headache. 2007;47(Suppl 1):S2-9. doi: 10.1111/j.1526-4610.2007.00671.x.
- Rasmussen BK, Jensen R, Schroll M, Olesen J. Epidemiology of headache in a general population--a prevalence study. J Clin Epidemiol. 1991;44(11):1147-57.
- Steiner TJ, Birbeck GL, Jensen RH, Katsarava Z, Stovner LJ, Martelletti P. Headache disorders are third cause of disability worldwide. J Headache Pain. 2015;16(58):1-3.
Improving the Odds: Lifestyle Changes for Hypertension
Every year, 38.9 million physician visits involve patients with essential hypertension as the primary diagnosis.1 This makes it the second leading cause of physician office visits (only routine infant/child check-ups are more common).1 Hypertension, as well as many other cardiometabolic conditions, tends to respond well to lifestyle changes, but how do we motivate patients to adopt lifestyle changes that are realistic, achievable, and truly effective?
For some practitioners, the challenge of lack of compliance for lifestyle changes can lead to feeling disillusioned and resigned, reluctant to discuss lifestyle changes that are still considered essential.2 Lifestyle change is hard, for hypertension as well as many other chronic conditions, but with the right tools, we can help our patients get it right.
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At IFM, we provide the framework, tools, and patient education materials that help make your counsel about lifestyle recommendations stick. A suite of materials provides clear instructions and motivational information that helps meet patients where they are and get them to where they need to be.
IFM’s Applying Functional Medicine in Clinical Practice (AFMCP) course provides the tools and materials that will help you assess readiness to change, current risk factors, and appropriate exercise prescriptions. You'll get the tools and the know-how to empower your patients to reverse chronic problems like hypertension, cardiometabolic syndrome, and other chronic issues. Join us at AFMCP and improve both your patient lifestyle conversations and your patient outcomes.
- CDC/National Center for Health Statistics. National Ambulatory Medical Care Survey: 2010 summary tables. Table 13. Centers for Disease Control and Prevention. http://www.cdc.gov/nchs/data/ahcd/namcs_summary/2010_namcs_web_tables.pdf. Accessed 8/31/2016
- Howes F, Warnecke E, Nelson M. Barriers to lifestyle risk factor assessment and management in hypertension: a qualitative study of Australian general practitioners. J Hum Hypertens. 2013;27(8):474-48. doi: http://dx.doi.org/10.1038/jhh.2013.9.
Healthier Patients, Happier Clinicians
By IFM Educator Shilpa Saxena, MD
Physician burnout is an increasingly common experience reported by nearly 46% of healthcare providers.1 Burnout in primary care physicians has increased over the previous decade not only in the United States but in Europe as well.2,3 Despite the variety of definitions that have been used to measure burnout, certain themes have tended to emerge, including:
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- emotional exhaustion or loss of passion for one’s work,
- depersonalization of patients,
- and decreased meaningfulness in work.4
According to a recent Medscape survey,1 the main causes of burnout can be grouped under clinical, operational, or financial frustrations. I probably don't have to tell you that bureaucratic rules and tasks rank highest as causes for physician dissatisfaction. These operational stressors further compound the frustration experienced when dealing with difficult patients or suffering from compassion fatigue.
Our society is experiencing a sharp increase in the number of people who suffer from chronic diseases such as diabetes, heart disease, cancer, mental illness, and autoimmune disorders. The current medical model is ill suited to prevent the massive clinical, operational, and financial stressors this places upon providers. Albert Einstein defined insanity as doing the same thing over and over and expecting a different result. We can choose to do something different.
Functional Medicine offers a different way to approach chronic disease, with a methodology and tools that are specifically designed to prevent and treat such diseases. Building upon our current medical knowledge, Functional Medicine allows you to use evidence-based therapies such as nutrition, diet, and exercise to build personalized therapeutic plans that can treat and sometimes even reverse chronic disease. For decades, the foundational course Applying Functional Medicine in Clinical Practice (AFMCP) has helped thousands of clinicians rediscover satisfaction in the workplace by improving their patient outcomes. Find the joy in practicing medicine again and join IFM for an experience that prioritizes both healthy patients and healthy providers.References
- Peckham C. Physician burnout: it just keeps getting worse. Medscape Physician Lifestyle Report. http://www.medscape.com/viewarticle/838437_1. Published January 26, 2015. Accessed January 4, 2017.
- Houkes I, Winants Y, Twellaar M, Verdonk P. Development of burnout over time and the causal order of the three dimensions of burnout among male and female GPs. A three-wave panel study. BMC Public Health. 2011 Apr;11:240. doi: 10.1186/1471-2458-11-240.
- Twellaar M, Winants Y, Houkes I. How healthy are Dutch general practitioners? Self-reported (mental) health among Dutch general practitioners. Eur J Gen Pract. 2008;14(1):4-9. doi: 10.1080/13814780701814911.
- Maslach C, Jackson S, Leiter M. Maslach Burnout Inventory Manual. 3rd ed. Palo Alto, CA: Consulting Psychologists Press; 1996.
What Can Clinicians Expect to Change After Attending AFMCP?Robert Rountree, MD
, describes his perspective on the top takeaways for clinicians who attend Applying Functional Medicine in Clinical Practice
(AFMCP). From techniques to increase patient compliance to tools for assessing and treating patients, clinicians walk away from IFM’s foundational course ready to make changes in practice.
Worrying Trends Suggest Increasing Morbidity
First, the good news: a recent longitudinal study found that in the US, longevity continues to increase.1 Unfortunately, the study also found that the proportion of a person’s life in which they could expect to live disability-free is decreasing—and that the young will have more years with disability than individuals over 65.1 Decreasing quality of life may continue to be all-too-common as the younger generation matures. As clinicians, we can help by promoting health and wellness for our patients, and doing it early and often.
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In the rush of a short patient visit, it can be challenging to focus on long-term health with patients. Yet as our patient populations become increasingly ill, we need strategies and patient education to help with lifestyle change. With the right tools, you can empower patients to make the changes they need.
One small step you can take to promote patient health and wellness is attending IFM’s five-day course, Applying Functional Medicine in Clinical Practice
(AFMCP). In an interactive learning environment built around patient cases, you’ll gain practice with a suite of intake and treatment tools. These tested tools will help you connect the dots for patients and guide them toward an increased understanding of how their daily decisions affect their long-term health.
Join the many clinicians who have decided to focus on patient wellness and chronic disease prevention at AFMCP. You’ll walk out the door with tools and techniques to focus on prevention and wellness promotion, helping you assess, diagnose, and treat the kinds of chronic conditions that lead to long-term disability. You can make a difference and increase the disease-free years your patients can expect to live.Reference
- Crimmins EM, Zhang Y, Saito Y. Trends over 4 decades in disability-free life expectancy in the United States. Am J Public Health. 2016;106(7):1287-93. doi: 10.2105/AJPH.2016.303120.
Functional Medicine Through Active Learning
For two decades, the Institute for Functional Medicine has offered its foundational 5-day program, Applying Functional Medicine in Clinical Practice (AFMCP). This groundbreaking program integrates science, research, and clinical insights to help treat and prevent chronic disease.
IFM continues to lead the way in transforming continuing medical education. Our clinical content has always been innovative, and our educational presentation format is state-of-the-art. Instead of hours of long lectures, at AFMCP you are engaged in an active learning experience. IFM leads the way in best practices for continuing medical education:
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- Case-based learning is the central presentation method for clinical material at AFMCP. By working with real patient information in small groups, you can hone your diagnostic skills and learn from your peers. The cases frame Functional Medicine in the context of patient care so you can immediately apply the tools.
- Learner-centered activities based on proven adult-learning methods assist you in understanding and applying the Functional Medicine Toolkit. The toolkit contains an impressive array of intake forms, assessment questionnaires, patient education handouts, dietary plans, and other resources. Structured activities provide experience in selecting the right tool, using it appropriately, and interpreting the findings.
- Experienced Functional Medicine Facilitators work with small groups of participants to answer questions and provide practical advice about how to apply the Functional Medicine model and use the presented resources in practice.
Join IFM for AFMCP and benefit from a collaborative, case-based medical education experience. You’ll come home ready to utilize these concepts immediately in your own practice. If you've been considering attending AFMCP, there has never been a better time to go!
Go Beyond Theory to Improve Patient Outcomes
The best learning experiences involve a dynamic interplay between theory and application. At IFM’s Applying Functional Medicine in Clinical Practice (AFMCP), attendees participate in their own learning and thereby acquire skills to apply immediately in the clinic.
Expert speakers lecture on the biochemical foundations of disease and wellness, while facilitated small group sessions and case studies help turn theory into practice. Experienced Functional Medicine practitioners guide clinicians in using these newly learned concepts for better patient outcomes.
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Detailed case studies illustrate how to use the tools and techniques of Functional Medicine to identify the underlying causes of disease, allowing you to go beyond symptom management and address the biochemical culprits of dysfunction. Many clinicians leave with a new perspective and agency, ready to achieve the outcomes they always dreamed of with their chronic disease patients.
Take the next step to advance your clinical practice. Join us at AFMCP and return to your clinic with a renewed sense of purpose, along with tools and strategies to assess and treat the underlying causes of chronic disease.
Lifestyle, Diet, and Helping Patients with Mental and Physical Illnesses
As the incidence of chronic conditions continues to rise, the proportion of Americans with mental health conditions has followed. Anxiety, depression, obsessive behaviors, eating disorders, and other conditions often occur in concert with health conditions such as metabolic syndrome, autoimmune disorders, and cardiovascular concerns. In fact, patients with mental illnesses may be more likely to come to the doctor's office with minor illnesses than patients without mental health diagnoses.1
Nutritional changes can address both physical concerns and mental health issues.
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Depression is known to be affected by nutrition: both its severity and duration can be modified by dietary changes.2
A connection between GI microbiota - which in turn are heavily influenced by diet - and mental health has been demonstrated for anxiety, metabolic syndrome, mood disorders, and stress management, among others.3
Studies have also linked poor nutrition to increased incidence of mental illness in adolescents4
while an improved diet has been correlated with better mental health in children and adolescents. Increasingly, psychiatrists are recognizing the primacy of nutrition in treating mental illness.7
How do you encourage patients to adopt new dietary habits and improve their nutrition as part of a treatment plan for both mental and physical illnesses? Join us at Applying Functional Medicine in Clinical Practice
(AFMCP), IFM's five-day foundational training course, and learn how to introduce lifestyle changes, assess patient behaviors, and encourage sustainable change.
The AFMCP curriculum gives you a roadmap for guiding patients through lifestyle change-including how to adjust your assessment, intervention, and follow-up protocols to focus on identifying underlying causes and selecting appropriate treatments. Dietary changes can seem challenging to many patients, especially those with mental health issues, but AFMCP can help you implement practical strategies with these patients that will actually work.
At AFMCP, you'll receive clinical tools
, including the Functional Medicine Matrix, detailed patient intake forms, and patient education documents that will help you communicate with your patients about lifestyle change. These tools will transform the way you work with patients, and you'll be amazed by the results.
- Hartman TO, van Rijswijk E, van Ravestijn H, et al. Mental health problems and the presentation of minor illnesses: data from a 30-year follow-up in general practice. Europ J Gen Pract. 2008; 14:s1, 38-43
- Rao TSS, Asha MR, Ramesh BN, et al. Understanding nutrition, depression and mental illnesses. Indian J Psychiat. 2008;50(2):77-82. doi:10.4103/0019-5545.42391.
- Zhou L, Foster JA. Psychobiotics and the gut-brain axis: in the pursuit of happiness. Neuropsych Dis Treat. 2015;11:715-723. doi:10.2147/NDT.S61997.
- Jacka FN, Rothon C, Taylor S, et al. Diet quality and mental health problems in adolescents from East London: a prospective study. Soc Psychiatry Psychiatr Epidemiol. 2013 Aug;48(8):1297-306.
- Liu J, Hanlon A, Ma C, et al. Low blood zinc, iron, and other sociodemographic factors associated with behavior problems in preschoolers. Nutrients. 2014;6(2):530-545. doi:10.3390/nu6020530.
- O'Neil A, Quirk SE, Housden S, et al. Relationship between diet and mental health in children and adolescents: a systematic review. Am J Pub Health. 2014;104(10):e31-e42. doi:10.2105/AJPH.2014.302110.
- Sarris J, Logan AC, Akbaraly TN, et al. Nutritional medicine as mainstream in psychiatry. Lancet Psych. 2(3): 271-274.