3X4’s new Functional Medicine Practitioner Spotlight series features interviews with practitioners, consultants and functional medicine thought leaders to explore everything functional medicine practitioners need to know about successfully building, managing, and growing their private practice.
The following is an interview we recently had with Bonnie Mackey, PhD, NP, APHN-BC, Certified Functional Medicine Practitioner, Mackey Health.
What can you tell us about your practice?
BM: I have been a holistic nurse practitioner since 1990, educated and trained both from a conventional and natural medicine perspective. I have a PhD in clinical nutrition. I have licenses to practice as a nurse practitioner in both Florida and New York. Services offered fall within the framework of authentic functional medicine, not anti-aging per se. The use of food as medicine, promoting all factors that constitute a healthy lifestyle and the use of both botanical medicines and prescription medications as needed, are included. I have been compounding botanical medicines and using them for over 38 years, writing prescriptions only as needed and usually as a second approach when botanical medications have not resolved the health issue. I have taught the clinical chemistry of plant based medicine and their use for various practitioners over the years as well. I have developed and offer an East-West approach to health, and am schooled in both sectors. Energy medicine, first using Therapeutic Touch modalities, various hands-on energy medicine, and PEMF therapies, were also a part of the practice. In addition, I supported and still support the use of bodywork, acupuncture, Yoga and other health-promoting modalities.
What surprised you the most when you started your practice?
BM: Starting my solo practice was based out of the need for it in the community. It was in the mid-1980’s when working at the University of Miami hospitals, as a main center for HIV/AIDS. I had discovered different strains of HIV due to different symptomatology, conducted HIV research, practiced as a clinician, provided a lot of end of life care and counseling, taught medical students and residents, created a community outreach program and came to realize that I was working in a somewhat “failed” healthcare system at the time. Since the early 1980’s, I had been using natural healing modalities, and incorporated those into treatment plans for the patients. However, this had to be done away from the hospital for the most part. What I was able to do, was to get orders from the doctors to allow massage therapy into the hospital, only allowed in the evenings. That allowed me to do energy work in the hospital with the patients. I couldn’t see why this wasn’t allowed as a regular part of healing and health but it wasn’t. Because I was known for how I practiced healthcare and utilized various healing modalities as well as the use of botanical medicines, it was not difficult to start a practice. The practice developed through word of mouth and continues to do so today. However, the medical community looked down on what I was doing as though it was quackery, thought of as being “out there” as a practitioner.
What surprised me the most was not understanding collegial judgement of who I was and the services I offered, as I offered a blended approach, a combined conventional and natural medicine approach, to healthcare. Colleagues knew I was a scientist at heart, through conversations and practice. There was little to no collegial support, but I endured. The manner in which I practiced and the services offered as a holistic practitioner for over 38 years, is now becoming recognized.
What was the biggest challenge you had to overcome as you built your practice?
BM: One challenge was getting some level of support from both practitioners and the insurance companies. There was little reimbursement for services but I did successfully bill for conventional medicine for a while.
How did I overcome it? Garnering support by colleagues was overcome in part, by doing community lectures and eventually being asked to be a speaker at physician-based education programs. It was also helpful to have the patients go back to their primary practitioners and share their stories and positive health outcomes. The latter was testimony to what I was offering through the services provided, which prompted awareness and acceptance of me as a practitioner.
To overcome the insurance reimbursement issue, I decided to go to cash or out of pocket-payment for services.
How I have overcome anything in the practice, is to find positive solutions to current issues. This is done by first identifying what the issues or challenges are, evaluating the challenges, modifying the plan to include new strategies and approaches, and living the positive outcomes.
What advice would you give to other practitioners considering launching their own practice?
BM: Launching one’s own practice takes planning, intelligence, wisdom, strong financial base, identifying individual strengths and weaknesses and selecting the appropriate people to provide guidance, as needed. It is also important to determine which camp you are in: functional medicine or anti-aging. If the practitioner is truly ingrained in the functional medical practice framework, it is important to be authentic in their approaches to healthcare per their education and training. Today, many are using the functional medicine language in their marketing, but they are not practicing authentic functional medicine. Instead, most are offering an anti-aging approach, which is very costly to the patient, and oftentimes does not have the research behind what is being offered, for most of these expensive services. While offering specific services is important, they need to be justified through science and what the patient truly needs. A patient’s needs are discovered through listening to the individual’s stories through their lifetime, as this is a very important piece to understanding the how’s and why’s they may be in their current state of health imbalance or ill-health. The latter is equally as important as keeping up with the science. In essence, self-exploration is key to determining the launch of any practice.
What excites you most about the field of functional medicine?
BM: What excites me most about the field of functional medicine is keeping apprised of the science. The manner in which I practiced was offered to patients long before functional medicine made its way forward to be recognized as a field in itself. Natural medicine principles and practice have been around a long time, and was not as fully explored, but is beginning to be explored and appreciated, by the Institute for Functional Medicine. Walking alongside the patient through their healing journey, and offering education and guidance using a blended approach to their health is nothing new, but the science that motivates expanded critical thinking and its application to each person, is a dynamic and much appreciated aspect of my practice.
Where do you see your practice 5 years from now?
BM: Given what I see happening with the fields of functional medicine and anti-aging, the tides have changed in ways that are not as aligned with how and why I have practiced healthcare. In addition, unlike over 38 years ago when there were so few holistic, integrative practitioners, there are now enough of these practitioners available to people. In 5 years, it is likely that I will be focusing on something more that is dear to my heart, which is the field of end-of-life care. I have had a lot of experience and education in this field throughout my career, yet this field could use additional attention. End of life care and planning is a very important part of a person’s health journey and health care, rarely addressed, even in the field of functional medicine. I am confident in my knowledge and expertise in the field of end-of-life care, but as always, I believe in ongoing continuing education and updated practice acumen.