3X4’s new State of Functional Medicine series features interviews with a diverse range of active practitioners and established thought leaders to learn more about why they chose the field of functional medicine, what excites them most about their work, the most common misconceptions they hear from patients, and most importantly — how they see the field evolving in the years ahead as healthcare shifts to be more personalized, proactive, and preventative.
Functional medicine practitioners play a key role in helping patients understand who they are so they can improve their quality of life which is what we’re all about here at 3X4. Our goal with this new series is to celebrate the work these practitioners are doing and inspire others to explore the exciting field of functional medicine.
The following is an interview we have recently had with Elizabeth Markovich, DNP, Integrative Healthcare.
Why did you decide to make functional medicine your focus?
EM: I started out as a family nurse practitioner after many years as an RN. After about five years in family medicine I spent a couple of years working with a rheumatologist. In rheumatology it became starkly obvious that we had nothing to offer but suppression of the symptoms. Patients were constantly asking me about very dubious natural cures and yet they did also report quite a bit of success at times. I started trying to educate myself through various books and programs to be in a better position to advise them. Eventually I settled on the Institute For Functional Medicine’s programs as the most science based.
Who have been your greatest mentors in your functional medicine journey?
EM: Honestly I have learned more from my patients than anywhere else. Early on I learned not to ignore a patient’s concerns and to be open to them when they wanted to share some experience or asked me to look at some article or type of therapy. People can learn an amazing amount when their own health is on the line. They often quickly become an expert in that condition.
What excites you most about your day to day work?
EM: I still face challenges every day and new problems clinically. Of course there are many times when I can’t help or when people are unable or unwilling to take the steps necessary. Still it is a thrill to help a patient get their life back.
What’s the most challenging part of your day to day work?
EM: The business aspect is the most challenging. Recently we have not had a real business manager. That is very difficult in a small practice so I’ve been doing quite a bit myself along with the bookkeeper. We are in insurance-based practice so there are challenges in that area. I would like to remain insurance-based since it really helps our accessibility to patients. Managing employees has been a big problem this year.
What do patients most commonly get wrong about functional medicine?
EM: I am fortunate to have many patients walk in the door understanding quite a lot about holistic or functional medicine. However many still don’t understand that there are going to be out of pocket costs for testing perhaps supplements and also a great deal of effort required on their part in terms of lifestyle change.
What’s holding the field of functional medicine back?
EM: I think the expense is difficult for very many patients. It is true that having that financial investment can be motivating but many simply can’t afford it especially by the time they’ve been ill or disabled for some years. Insurance payments for functional medicine testing are quite limited and insurance doesn’t truly reimburse the more intensive type of office visits required.
What has your experience been with genetic testing?
EM: I have used Genomind, primarily for medication choices and problems with medication reactions. We have also used Pure Genomics, offered by the Pure supplement company. This is a pretty good look at detoxification and methylation at minimal cost, really no cost if the patient already has a panel such as 23andme done. I am familiar with many variants or snips. But it’s only a very small proportion of the meaningful information in a genomics profile so most practitioners need the computer analysis to interpret these profiles.
How do you see the practice of functional medicine evolving in the years ahead?
EM: I do think genomics will play a larger role in the next few years. I think the word on science-based functional medicine is gradually getting out. However there may be huge societal changes and aging of the population ahead, perhaps other pandemics, so it is hard to predict the impact on the average person.
About Elizabeth Markovich.
Elizabeth is a Family Nurse Practitioner certified with the American Association of Nurse Practitioners. Her Master’s of Science in Nursing and Doctor of Nursing Practice (DNP) degrees are both from Florida State University. She is also a Certified Functional Medicine Practitioner through the Institute for Functional Medicine (IFMCP), completed last fall after 8 years of study. She has extensive experience in general family practice medicine and in rheumatology. She has a special interest in treatment of hormone imbalance, thyroid problems, reducing heart disease and diabetes risk, digestive problems and pain.