Holistic approaches to medical care, including integrative and functional medicine, are on the rise, raising an important question: Do these approaches fit into our existing, traditional health care model or are they intrinsically incompatible? History might indicate that they are incompatible, as two 19th century medical luminaries – Louis Pasteur and Claude Bernard, the fathers of germ theory and physiology respectively-- have been characterized as representing competing theories: traditional or Western medicine vs. functional and integrative medicine.
In the 1860s Pasteur established the science of bacteriology by showing the connection between bacteria and disease processes. His work led to the pasteurization of milk, the inoculation of cattle and chickens to prevent anthrax and cholera and vaccination to prevent rabies in people and dogs. Pasteur published his germ theory, proving that food spoiled because of invisible living organisms, not spontaneous generation, which asserted that living organisms could emerge from nonliving matter, and that germ theory also applies to humans. In sum, infection and disease occur when the body is invaded by microorganisms.
Bernard, another physician recognized as the father of physiology - the science of how cells, tissues and organisms function – was working in Paris at the same time. He established experimentation on animals as the accepted method for studying disease processes to improve medical care. He’s credited with discovering homeostasis, the self-regulating process by which biological systems maintain internal stability while adjusting to external conditions, and the view that maintaining balance in the host organism matters. He asserted that disease occurs when homeostasis is disrupted.
While Pasteur and Bernard were acquaintances and may have even been rivals, it’s not at all clear that their theories are as incompatible as has been suggested. Modern medicine has indeed focused on identifying and treating disease processes in the vein of Pasteur while de-emphasizing the role of nutrition as well as other strategies for preventing disease, such as sleep, physical activity and managing stress and anxiety. However, scientific advances supporting the role of sleep and the gut microbiome in our health, including our immunity, metabolic and mental health, have contributed to the conceptual basis and popular demand for a more proactive approach to health that seeks to re-establish homeostasis, including a food-as-medicine perspective.
While much of medicine remains disease-focused, functional and integrative care models increasingly are coexisting with mainstream practice in academic medical centers and health systems. In fact, they are experiencing growth despite a largely self-pay model.
Will the best of functional and integrative medicine eventually be incorporated into mainstream medical care? And what would it take to achieve this goal -- a stronger evidence base, payment models that reward physicians and clinics for preventing and managing chronic disease, continued consumer demand and new medical school curricula? It’s likely that all of these will come into play so that, in some form and at some point, functional and integrative medicine will no longer be “alternative.”
