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RHR: How to Build a Career in Paleo / Functional Medicine

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Revolution Health Radio podcast, Chris Kresser

It became really clear to me that I needed to figure out a way to train people in my approach, and generally, get more people involved in this kind of functional, ancestral approach to medicine. That’s because as one person, there’s a limit, of course, to the number of people that I can help on a one-on-one basis. That’s especially true because I only see patients two days a week, which leaves me time to do my research, writing, teaching, and all of the other activities that I do.

In this episode, we cover:

2:00  What Chris ate for breakfast
5:30  Introducing Dr. Amy Nett
8:20  Introducing Dr. Sunjya Schweig
10:46  The California Center for Functional Medicine
15:45  How do you pursue a career in functional medicine?
21:34  Current training options
27:40  Formal clinician training program

Show notes:

Steve Wright:  Good morning, afternoon, and evening.  You are listening to the Revolution Health Radio show.  This show is brought to you by ChrisKresser.com.  I’m your podcast host, Steve Wright from SCDlifestyle.com.  With me is integrative medical practitioner, healthy skeptic, and New York Times bestselling author, Chris Kresser.

Chris Kresser:  Hey, Steve.  How’s it going?

Steve Wright:  Pretty good.  I’m trying a new intro.  What do you think?

Chris Kresser:  I like it.  You nailed it.

Steve Wright:  Perfect.

Chris Kresser:  Tell us if you got an elk last weekend.  Last we checked in with you, you and Jordan were heading out to be hunter-gatherers for the weekend.

Steve Wright:  Yes, yes.  We were using bow and arrows to try to gather some meat.  The elk, while they are massive, are very elusive.  We never got close to them.  Luckily, we did get gifted with a doe mule deer that Jordan was able to harvest with his bow.  It was a pretty amazing hunt.

Chris Kresser:  Oh, wow.

Steve Wright:  It was between 30 degrees and 50 degrees the whole time and downpouring.  So yeah, we had to put our work in.  But it was cool.  It was a very grateful and amazing journey.

Chris Kresser:  Awesome.  Are you doing primitive skills, gathering and stuff like that too?

Steve Wright:  I think that will be next year.  This is my first foray into sort of hunting.

Steve Wright:  I’ve been a fisherman my whole life.  In November, I’ll be headed out elk hunting here in Colorado.  We’ll see what happens.

Chris Kresser:  Cool.  Keep us updated.  That’s really great.

Steve Wright:  Thanks. When you got up this morning, you probably had breakfast.  What did you eat?

What Chris Ate for Breakfast

Chris Kresser:  I did have breakfast this morning.  As you know, I don’t always.  I’ve been having this Brazilian fish stew leftovers for breakfast for the past couple of days.  It’s an amazing recipe.  It came from Simone Miller’s book, The Zenbelly Cookbook.  She catered my book launch party, which was incredible.  She’s one of the bona fide chefs in the Paleo movement.  There are a lot of Paleo cookbooks I think that are not particularly great from a culinary perspective.  There are people who are really passionate about Paleo, it helped them, and then they decided to do a cookbook, but they don’t necessarily have a lot of skill or experience in the kitchen.  Simone is definitely different in that regard.  So we’re really enjoying her cookbook.  It is a fish stew made with rock cod, coconut milk, tomatoes, potatoes.  We added potatoes, it didn’t normally have potatoes in it.  Lime, lemon, some really nice spices.  Really, really fresh, great flavor.  That’s what I had for breakfast.

Steve Wright:  Sounds delish.  I want to have that for dinner tonight.

Chris Kresser:  Yeah, check it out.  So we have a really great question.  Actually, three questions that we’re rolling into one.  We’re going to play back one of them, but I’ll tell you a little bit about the others.  They’re all in the similar topic, which is education, and what people do when they want to pursue a career in functional medicine or ancestral health.  We figured we would answer this question today, because I have a couple of announcements that are also relevant to that.

Steve Wright:  Drum roll, please.

Chris Kresser:  It made sense to roll all those together.  If you’ve been listening to this show for a while or following my work, you probably know that my practice has been closed to new patients for at least a couple of years, and really, kind of the better part of the last four years.  There have only been a couple of periods of open enrollment where I was accepting new patients.  The last time we did that, we had about 600 people join the wait list in four days.  It took me about two years to work through all those people in the wait list.  I’m happy to announce that finally, I’ve done that.  So very soon—actually, I think by the time you’ll be listening to this show, we will have reopened to new patients.  You may have seen a blog post about that, or you will see it either today or very shortly.  The caveat is I have no idea how it’s going to go.  I have no idea how many people are going to sign up.  If it’s a lot of people, we may need to do a lottery, like we did last time, where we randomly assigned people a position on the wait list.

This leads to the second announcement, which is with that last experience, where we added so many people to the wait list in such a short period of time, it became really clear to me that I needed to figure out a way to train people in my approach, and generally, get more people involved in this kind of functional, ancestral approach to medicine.  That’s because as one person, there’s a limit, of course, to the number of people that I can help on a one-on-one basis.  That’s especially true because I only see patients two days a week, which leaves me time to do my research, writing, teaching, and all of the other activities that I do.

Introducing Dr. Amy Nett

There are a couple of developments on that front that I want to share with you.  Number one is that I have hired a clinical associate that I’ve been training and who’s been working closely with me for the past several months.  Her name is Dr. Amy Nett.  She’s an MD, went to Georgetown University School of Medicine.  She did her residency in radiology in Stanford, and then pediatric radiology in Stanford as well.  She is an extremely sharp, intelligent person, with a real thirst for learning.  To me, that’s one of the most important qualities you can have as a clinician.

While she was at Stanford and seeing pediatric radiology patients—these were kids that were coming in with obesity, diabetes, autoimmune diseases—it became really clear to her that conventional medicine was not the answer, was not the way to help these kids, and that these were all preventable diseases that Western medicine is not doing a really good job with.  She made the decision to transition into a more functional medicine career or approach.  She applied for the associate position that I advertised for a while back.  Out of the 70 applications that we reviewed, she was the one that I chose.  She’s been with me since June.  She’s been shadowing me in the clinic.  Pretty much every appointment that I do, she’s with me.  She’s been studying all of my protocols.  We’ve been having regular meetings.  She already has a pretty high level of understanding of the principles of functional medicine and she’s very familiar with my protocol.  She’s been a huge help in the clinic so far, communicating with my patients.  She’s doing all of the initial appointments with patients prior to the case review that I do.  Then she’s already starting to do some follow-up appointments.  Probably within the next three to four months, she’ll start seeing her own new patients as well.  So I’m super excited to have her on board.

We’ve had a lot of great feedback from my patients so far.  If you are a patient in my practice right now, just know that Amy’s on board, and she’s available for follow-up appointments.  I still directly supervise her.  We have regular communication.  If there’s anything that’s not clear to her, she talks to me about it.  We work as a team.  So that’s really exciting.  In the next couple of years, I plan to hire more people.  I will probably have a nurse practitioner on staff or a physician assistant to help with communication in-between appointments, and registered dieticians in addition to that.  We’re really expanding the clinic, so we can serve more people.  That’s exciting.

Steve Wright:  That’s really cool.  Congratulations.

Introducing Dr. Sunjya Schweig

Chris Kresser:  Thank you.  Then the second announcement, which is kind of directly related to that, is that I have joined forces with a functional MD who’s also a friend of mine, named Dr. Sunjya Schweig.  You met Sunjya on the podcast, maybe a few months ago, we had him on to talk about chronic infections.  So you may remember him from that.  He recently relocated to Berkeley from the Santa Rosa area, where he was practicing functional medicine.  He is an amazing clinician.  He’s actually my doctor.  I don’t go to the doctor very often, but when I do, I talk to Sunjya, I trust him implicitly.  I have a lot of respect for him as a clinician and as a person.  He has 15 or 20 years of experience in the alternative, functional, integrative medicine worlds.  He’s trained with a lot of very well-known practitioners.  He is really sharp.

What I appreciate about him the most is that he is not dogmatic, and he doesn’t have a shtick.  What I mean by that—and I’m sure a lot of people out there have experienced this—is really, often, in the medical world where you’re talking about conventional medicine or functional medicine, you’ll see clinicians that have a certain perspective.  Maybe it’s Candida or fungal overgrowth, or maybe it’s Lyme, or maybe it’s mold illness, or maybe it’s leaky gut.  Then every patient that walks through the door, they see them through that lens.  It’s something that you really have to guard against as a clinician, because while having a framework like that can be really helpful and an easy way to organize your thinking with patients, it’s a trap, because everybody who comes through the door is different.  The pathology and etiology of disease is extremely complex, and it manifests differently in every person.  We have to be really careful not to apply a framework or template-based approach, given our favorite diagnoses.  Sunjya is really amazing that way.  He’s experienced with chronic infections; that’s one of his specialties.  But he doesn’t shoehorn everybody into that diagnosis.  He’s very open-minded.  He’s always learning and seeking to expand his knowledge.

The California Center for Functional Medicine

We just had such a similar perspective on patient care, functional medicine, ideas and visions for the future, and how we can revolutionize healthcare, that we decided to merge our practices together.  So we’ve done that.  We’ve created a whole new entity called the California Center for Functional Medicine.

Steve Wright:  Oh, wow.  Cool.

Chris Kresser:  This is our new clinical entity.  It’s myself, Sunjya, and Dr. Amy right now.  Very shortly, I think we’re going to be hiring a physician’s assistant or nurse practitioner.  The vision is, in a few years’ time, to have Sunjya and I in the co-director positions of the center, and we’ll have several clinicians working with us—doctors, naturopaths, nurse practitioners, physician’s assistants, and registered dietitians—all of whom share a functional medicine approach, and also the combination of a functional and ancestral medicine ideal.  So there is lots of stuff going on in the clinic and education side.  I just wanted to share that before we get into the questions.

Steve Wright:  That’s amazing, Chris.  This new joint venture or the new thing, is it going to have a website?  Is it a physical product?  Like, are people going to come visit you guys?

Chris Kresser:  Yeah, it’s kind of a hybrid model.  My practice, I do have a physical office where I see patients, but I also consult with people via Skype/on the phone around the country.  That will continue.  So I’m going to keep my office where it is.  Sunjya has an office in Berkeley that he’ll keep where it is.  Because he’s a physician and because of licensing board requirements, he has to do his first appointment in person, whereas I’m not limited in that way.  But he can do phone consulting after that first in-person appointment.  Amy will work out of my office.  She may also have an office in the South Bay, which is where she lives.  Eventually, we may have a dedicated physical space for the California Center for Functional Medicine.  But at the moment, we like the distributed model.  There’s a lot of flexibility.  It keeps our overhead lower, which means our fees can be a little bit lower.  It’s working.  So we’ll see.  I’m not sure yet.

Steve Wright:  Awesome.  This is all very exciting.  I’m sure it’s going to help a lot of people.  Congrats.

Chris Kresser:  Thank you.  Now we’re going to play back one of these three questions that were all related.  As you’ll see, this is related to the topic that we’re talking about now.  This is from Justine.  Let’s give it a listen.

Justine:  I really want to study.  I trained, supposedly qualified as a nutritionist about 10 or 15 years ago, but didn’t really have much faith in what I’d learned.  And I’ve learned a lot more over the years.  But I think the science is constantly changing, and there doesn’t seem to be a course out there that I feel could really qualify me.  I’d probably do better following you and following other people.  Do you have any plans to put all the information you have into a learning type format, where people can sort of learn and—apart from, obviously, just reading all your useful information.  If not, who would you recommend or where would you recommend to study?  Thanks so much.

Chris Kresser:  I get a version of this question or almost this identical question probably five to six times a week through e-mail, comment on Facebook, or the blog.  We also got a question from Peter from Sweden.  He has a similar question, although in his case, he doesn’t have the certification in nutrition that Justine had.  He’s wondering where he should start.  He wants to study with the Institute for Functional Medicine, which is a functional medicine training organization, but they require some license.  They only admit licensed practitioners, so he’s wondering what kind of license he should get: a naturopath, should he go into medicine, conventional medicine.  Then Kyle also sent a similar question.  He’s 20 years old.  He’s a college student who’s majoring in biology.  He said he wants to do something along the same lines that I’m doing, and wasn’t sure where to go after his undergrad work, osteopathic medicine was one thing he was thinking about.  Because so many people asked this question, I want to talk a little bit about it.  I also want to make another announcement that is relevant to this whole discussion.

Steve Wright:  Blowing our minds, four announcements.

How Do You Pursue a Career in Functional Medicine?

Chris Kresser:  Yeah, I saved them all up.  People ask me this a lot in person, when I travel as well.  The answer to the question of, “How do you pursue a career in this field?” really depends on what you want.  The first thing you need to figure out I think is—this is the way I approached it—how do you want to help people?  How do you want to spend your time?  Do you imagine that you mostly want to talk about nutrition and lifestyle?  Would that be satisfying for you?  Or do you want to really dive into the more intensive, complex, chronic disease treatment, where you’re working with patients for whom diet and lifestyle changes may not have been enough?  And you want to do lab testing.  You want to get into supplements and botanicals, and maybe even medications.  That’s obviously a different choice.  Do you imagine yourself working within the existing conventional medical structure?  Is that important to you?  Do you want to be able to get a job at a hospital or within an existing medical clinic?  Or do you imagine yourself working outside of that structure, in a private practice type of situation?  That’s another important question.  A third question would be, how important is it to have the credibility that comes, almost without question, with certain Western or conventional medicine degrees?  Such as a medical doctor.  There’s a lot of history and cultural recognition around that degree.  When you have an MD after your name, you have an instant credibility, almost whether you deserve it or not.  And that’s not a dig against doctors.  It’s an interesting thing that when you have those letters after your name, you’re assumed to be an expert, even on topics that you don’t necessarily have expertise in, like nutrition, for example.

Most doctors will tell you that their education in nutrition is just hideously minimal in medical school.  Yet doctors are often consulted as if they are experts on nutrition.  But there’s a certain credibility and authority that’s instantly confirmed when you have a degree like that.  There are other ways to build credibility and authority outside of that, but they can be a little more difficult, a little more circuitous.  So that’s also something important to know.  And there’s no right answer to any of these questions.  These are all very personal questions.  They depend on your own proclivities and personality, and the way that you operate in the world.  But they’re the key questions you need to be asking in terms of figuring out what direction you want to go, particularly if you’re a college student and you’re deciding what you want to do with the rest of your life.

I would say if you just want to work in nutrition and lifestyle, then becoming a registered dietitian or a nutritionist of some sort if probably sufficient, and that’s as far as you really need to go.  If you want to get more into the functional medicine side and help people on that level, where you’re doing lab testing and prescribing supplements and medication, then getting some kind of license I think is important.  So you could be a naturopathic doctor, a medical doctor, an osteopathic doctor.  In some states, an acupuncturist, a specialist in Chinese medicine, like me.  I say some states, because the regulation of these degrees and professions is different in different states.  In California, acupuncturists are considered to be primary care providers in the workers’ compensation system.  It’s a four-year master’s program, which includes two years of allopathic medicine.  We learn pathophysiology, pharmacology, anatomy, physiology, internal medicine.  We study a lot of the same thing that doctors study, so that we can make diagnoses within the workers compensation system.  We’re allowed to order labs.  It’s all part of our scope of practice.  But in other states, that’s not true for acupuncturists.  So you would need to really understand what the regulations are in your state.

I think the question everyone’s asking here is, once you have your degree—whether it’s as a registered dietician, a doctor, a naturopath—how do you get the training that you need in functional medicine and ancestral medicine that’s really going to make you successful in the clinic, and really going to allow you to approach things from the perspective that you want to?  Because I don’t care what program you do, whether it’s an MD, naturopathic doctor, acupuncture, osteopath, registered dietician.  The bad news, perhaps, is that’s just the starting place.  That gives you the basic background that you need to be successful and to go forward and do what you want to go.  But as I’m sure everybody out there who’s gone through those programs will tell you, you don’t come out of there as a functional medicine expert, and Paleo/ancestral nutrition and health expert.  There’s no formal program that is teaching those things.  You have to acquire that knowledge elsewhere.

For me, I started doing that when I was still in school.  I started taking continuing education, workshops and seminars, and studying with other teachers in the world of integrative and functional medicine before I even finished school, because that was what I was interested in, and that’s what I knew that I wanted to do.

Current Training Options

So here we come to the announcement, or maybe even before that—let’s talk a little bit about the current functional medicine training options.  There aren’t that many.  So there’s the Institute for Functional Medicine training program, which is probably the best known.  There are some excellent courses there, great instructors.  Mark Hyman is on the board, he founded that and put that together.  I have a lot of respect for him and his work.  That’s kind of considered to be the main functional medicine training organization.  Then you have Dan Kalish’s program.  Dan is a friend, a colleague, I have a lot of respect for him and his work.  He focuses mostly on gut, adrenals, and male and female hormones.  He doesn’t get into blood work, functional blood chemistry, blood sugar, thyroid, cholesterol, lipids, any of that sort of stuff.  He’s really focused on the gut, hormones, and adrenals, which is—you know, those are super important and you’re going to help a lot of people when you learn to deal with those problems.  There’s Reed Davis, Functional Diagnostic Nutrition, which is more of a nutrition kind of approach, with some functional medicine mixed in there.  There’s one more that unfortunately, I’m not remembering.

Steve Wright:  I think it’s Functional Medicine University.

Chris Kresser:  That’s right.  FMTown maybe is it?

Steve Wright:  I haven’t heard of that one.  But I know there are some new ones that are cropping up.

Chris Kresser:  Right.  There are a few cropping up, and there’s probably going to be more.  All of these programs I think have strengths; all of them may have some weaknesses.  Certainly, there is a lot of good in all of them.  For quite a long time, I have been considering doing my own training program.  I’ve had a lot of requests from people to start teaching my particular approach to functional medicine.  What I’ve seen, at least from seeing all of the different training programs that are out there, I think there are a couple of needs that aren’t being met.  First, maybe the most important for people that are listening to this, is a training program that encompasses functional medicine from an ancestral health perspective.  There’s no program that’s doing that right now.

Steve Wright:  What does that mean, Chris?  Because I don’t know if that’s really clear.

Chris Kresser:  If you go to the Institute for Functional Medicine, a lot of the dietary recommendations will be more like a plant-based diet type of perspective, a more typical low-fat, lots of juicing and kale, talk about kale and fruits and vegetables.  I have nothing against kale, but there’s almost like this religious devotion to kale within those circles.

Steve Wright:  I was at the supermarket yesterday.  I saw three books, that all they were about was kale—three different books that were on the shelf.

Chris Kresser:  Yeah, it’s like this kale obsession.  I mean, kale is fantastic, I eat it a lot.  But if you want to get obsessed with a food, it should be liver, in terms of nutrient density.  We’ve already talked about that.  But you’re not going to see books with like a big slab of liver on the cover.  It’s just not the same.  The dietary recommendations will be different, right?  They’re not talking about things like artificial light and its effect on sleep patterns, and they’re not talking necessarily about the importance of reducing sitting time and integrating movement throughout the day.  They’re not talking about pleasure and how that’s been a part of our ancestral heritage, and how important it is to integrate this.

This lens that we look through, in my work, anyone who’s been following me for a while, this is the context that we are talking about things in.  It’s the evolutionary framework.  It’s the understanding that as human beings, we’re hardwired for a certain diet and lifestyle.  And when we shift away from that in this modern lifestyle, that’s when we suffer.  That fundamental evolutionary perspective informs everything.  It informs the way that we talk about diet, the way we talk about exercise, the way we talk about lifestyle.  It really informs my approach to functional medicine, to research.  For example, if there’s a conflict in the modern clinical research, we can look through the evolutionary lens to see if we can resolve the conflict that way, and we often can.  So it’s a huge part of my approach, my way of working with patients, my way of understanding functional medicine, and just health and disease in general.  And that’s lacking from all functional medicine programs right now.  I really wanted to create a program that would merge those two things together, where we’re studying functional medicine, but we’re studying it within this framework, context of evolutionary medicine.  So that’s the one thing.

Another thing is from what I’ve seen with a lot of the programs, they’re either almost too simplified and focused just on practical application, without enough real understanding of what’s going on, or they’re too didactic, which means there’s like a fire hose of information, but there’s very little information on how to implement that in your practice, when you get back to the clinic on Monday morning.  And there’s very little on how to set up systems.  Like, running a functional medicine practice is really different than running a conventional practice.  There are certain best practices, ways to set up systems, that will help you succeed—that kind of falls into practice management.  Then there are resources that you can develop—handouts, cheat sheets, slide presentations, all these things—that can help you build your practice, retain your patients, and provide extra value to your clients and patients.  That sort of thing is not being offered.

Formal Clinician Training Program

I want to create a training that is cutting-edge functional medicine from an evolutionary perspective that also supports people from a practice management and practice-building perspective.  That’s what I’m going to do.

Steve Wright:  I’d like to reclaim a word you said earlier, Chris.  It sounds like what you’ll be teaching—and I’m glad you’ll be teaching it—is a framework to be able to execute functional medicine.

Chris Kresser:  Yeah.

Steve Wright:  Earlier, you said framework.  But I think you mostly meant, like, lens that are bent on sort of seeing everything as, “Everyone has Candida,” or, “Everyone has thyroid issues,” something like that.  I think that’s really needed, and there is a big need out there to integrate natural ways of doing functional medicine through supplements and things that are available on the market, as well as all of the knowledge that’s available through the conventional medical system.

Chris Kresser:  Yeah, I’m excited about it.  The reason I haven’t done this sooner—a lot of people have e-mailed me saying, “What’s up?  When are you going to do this?”  I really took months to think about this.  There were so many different iterations, and journaling, and sketching things out, and whiteboards, trying to figure out the best way to approach this, what’s the best way to put all this together and deliver it in a learning environment?  And I finally figured it out and I’m really excited about the structure we’ve developed.  I’ll tell you just a little bit about it.

I just did a blog post where I mentioned this and you’ll see that there’s a functional medicine systems model that I developed.  It’s a series of concentric circles.  It’s the way that I understand how disease develops.  The core of that circle is environment.  Another word for it actually that’s fairly new is called the exposome.  This is what scientists are using now to refer to the sum total of environmental influences.  That’s everything that’s nongenetic.  So it could range from diet during our lifetime.  But not only that, it’s our mother’s diet during her lifetime and our father’s diet prior to conception, which we now know influences our health.  Mother’s diet during pregnancy.  It’s early life influences, like whether we were born vaginally or via C-section, whether we were breastfed or fed formula, stress levels of our primary caregivers.  Then the status of our gut flora, our exposure to antibiotics and other medications early on in life, that would have influenced the development of our gut flora.  Our exercise and physical activity, stress levels, exposure to environmental toxins like mercury amalgams, BPA, volatile organic compounds, pesticides.  It’s pretty mind-blowing to think of that, but that’s all encompassed within this term called the exposome, environmental influences.

Then the next ring out from that are genetics and epigenetics.  The environmental influences that we’re subjected to or exposed to interact with our unique genome and epigenome, to then express or manifest in certain underlying patterns or mechanisms of disease.  So these could be blood sugar dysregulation, autoimmunity, problems with methylation, digestive issues, leaky gut.  Then these mechanisms, in turn, express certain diseases.  So diabetes, heart disease, irritable bowel syndrome (IBS), all the things that Western medicine is kind of focused on.  Of course, these diseases and mechanisms then ultimately express themselves as symptoms that we experience as people and patients.

When you understand disease and health from that perspective, then that can serve as the framework for how you go about treating patients in the clinic, and then how I would go about teaching you how to do that in the training program.  The first module that we’re hopefully going to launch in the spring, maybe late spring of next year, is going to be all about the exposome or environment.  So how to modify all of the modifiable environmental factors to create the healthiest starting place, core fundamental foundation for health.  That will be looking at how to change diet, lifestyle, and some of these other influences for a whole variety of health conditions and needs.  So for someone who comes to see you and they have Hashimoto’s, they have a number of symptoms, but they’re also training for some competition, how do you address that person?  How do you address someone who wants to lose weight, but who tried a low-carb diet, and it’s not working for them?  How do you address somebody that has high cholesterol, high blood pressure, and their doctor wants to put them on medication?  What are the sorts of things, interventions that you can do for that person to normalize their function without resorting to medication?  This will be heavily focused on ancestral, you know, nutrient-dense diets, you can call it Paleo, Paleo-based.  But as anyone listening to this knows, I’m not dogmatic about Paleo, it’s more of a starting place and a template for me than anything else.  When it comes down to it, this is at least 80% of what you should be doing in any clinical encounter, no matter if you’re a doctor, a nutritionist, osteopath, or naturopath.  If you address these core environmental factors in your patients or clients, you’re going to heal 80% of people.  Even in a complex patient, you’re going to deal with 80% of the difficulty that they’re experiencing.  It’s this whole 80/20 rule that I’m sure you’ve heard of.

Then the next step out from that, which will be the second module of the training, will be the core functional medicine approach.  That’s where we’ll deal with the fundamental mechanisms that, again, if you address them, you’re going to deal with 80% of the next round of problems.  That will be blood sugar, nutrient deficiencies, gut, and adrenals.  Those are really the core foundational things you need to be able to address as a functional medicine practitioner.

Then from there, we go out to some of the more advanced mechanisms that you’ll encounter and need to deal with, like methylation, environmental toxins and metal toxicity, things like mold illness, chronic inflammatory response syndrome (CIRS), more advanced functional blood chemistry, lipids and heart disease, male and female hormones.  But these are all things that are peripheral to the core environmental factors and the core mechanisms like gut and adrenal.  So they come later.

Eventually, further down the line, I’ll have classes or shorter, focused modules that are on specific disease conditions, like Parkinson’s and dementia, and how you approach those conditions from the functional evolutionary perspective.  But we can’t do that and we can’t do those classes until you have that core foundation, moving out from the center.  So that’s the big announcement around education and training.  That first module, the environmental exposome module, I think will be open both to licensed and unlicensed practitioners, because we’re just going to be talking about diet and lifestyle, maybe some supplements.  The core functional medicine training will probably be open only to licensed practitioners, because it involves a lot of lab testing that is only available to licensed clinicians.  This training will be offered virtually in many cases.  So people from overseas should be able to do it, all around the country.  There will also I think be some in-person training opportunities via workshops and seminars that are either optional or standalone.  For example, I may offer the whole environmental piece virtually, and I also may offer it as an in-person workshop.  There’s going to be opportunities for both.  I think that’s most of what I can tell you right now.  We’ll be sharing more details as the time progresses.  I’m really excited about that, and I hope you are too.

Steve Wright:  I think you started mentioning this style of training probably at least two years ago.  So this is amazing to still be talking with you, Chris, and still bringing the podcast to people.  And now, we’re starting to see the birth of this brainchild of yours.  Very exciting news.

Chris Kresser:  Yeah, it’s been a long time coming.  I’ve had a lot of help and people who’ve been instrumental in helping to shape this.  I think it’s going to be great.  Definitely let us know what you think or if you have any questions, just post them in the comments section of this podcast episode’s blog post.  We’ll be back next week with another question.

Steve Wright:  Keep sending us your questions, everyone.  In-between episodes, please go over to Facebook.com/ChrisKresserLAc and Twitter.com/ChrisKresser.  If you follow Chris on these social media outlets, you’re going to get his updates on the studies he’s reviewing.  You might be the first to know about a new blog post or this practitioner training, or even the opening of the clinic, because depending on where you’re consuming information, you might get it before your e-mail.  So make sure you sign up there.  Thanks for listening.

Chris Kresser:  Thanks, everyone.

134 Comments

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  1. I hope you will look in to the requirements for physical therapy today. PTs graduate with masters level education with lots of physiology, anatomy, pathophysiology, pharmacology, etc. I work with chronic pain and I can easily get people 50% better at least. I routinely address sleep, lifestyle, exercise, “mindfulness” including Tai Chi, Yoga, meditation. I know that the part that I have difficulty and where I am having great difficulty with is the dietary aspects. Pretty much everyone that comes in to my clinic has digestive issues and taking meds for GERDS, sleep problems, thyroid, metabolic disease, etc. The present doctorate of education in PT has many of the pre-requisites you mention (prior to PT, the entry level requirements are the same as pre-med) are covered in physical therapy. Adding a functional nutrition component with at least some level of understanding of the systemic inflammatory issues, thyroid issues, metabolic disease issues, etc. would be huge for interested PTs. I think this would be awesome.

    • Hi Herb,

      I’m definitely aware of the rigor of many non-licensed programs, and open to being flexible. As I’m sure you know, I am operating in a much different capacity than most licensed acupuncturists, so I realize that a license is only part of the picture. We will continue to consider this. Thanks for your interest!

      • I am not sure what you mean by “non-licensed.” Physical therapists are licensed in all 50 states. National board examinations. In order to sit for the national boards requires completion of 3 years of post graduate training. PTs graduate with clinical doctorates in all 50 states. I will gladly forward you the national guidelines for physical therapy training. We have extensive training in pathology, pharmacology, neurological disease. We treat in hospitals, out patient clinics, rehabilitation centers. I think you are missing out on a group of people that are a perfect match for the complementary medicine aspect of what you are planning to offer.

        • Herb,

          Sorry for the mix-up, I was replying to the wrong comment. PTs are licensed so would definitely meet the requirement.

          • Excellent to hear this is happening. I have looked in to the various programs and based on your books,, website info and podcasts, (as well as personal success with your recommendations) I was hoping you would put together a program. So, excellent! Given the interest, I want to be the first to send in a check!

          • Hi Chris,

            I am a licensed DPT in Missoula, MT looking into functional medicine certification. We’re licensed, but can’t order labs at this point – are you still accepting PTs to your program? I’m considering training with Garric Vosloo (garricvosloo.com), a functional med certified PT. Have you heard of him or anything about his program?

            Thanks for all your guidance!
            Kate

  2. Hi Chris I am an RD in Sonoma County and have recently started following you and like so many others I am incredibly inspired by the work you do. I know many dietitians in functional medicine who work closely w/physicians or acupuncturists, order labs under MD’s name and are very involved in interpreting the labs results as well as suggesting supplements. I am unclear if you are going to be extending the second tier of your training to RDs but I am hoping you will consider doing so. Thanks for the work you do.

  3. This is exciting news Chris! I’m an L.Ac. in MA and I’m not completely sure if my license allows me to run labs. I’m currently taking the FDN course and we can run labs under what they call their Medical Director Program. This allows non-licensed practitioners and/or practitioners who have licenses, but their license doesn’t allow the running and interpretation of labs, to do so under the FDN staff doctor. Will your course offer something similar? Also, do you have an estimation of the cost of the course? Thanks!

    • Hi Rebecca,

      That is one option we’re considering, and I’m looking into the legalities involved. Thanks for the suggestion!

  4. Chris,
    I’m really looking forward to see what you develop with your modules/classes. I’m a MD with initial training in family medicine and now dermatology (talk about a specialty far from ancestral and functional medicine) and have learned a lot from you (reading then pulling studies on the ideas you’ve mentioned). From reading through the comments, you have a wide audience of really educated professionals interested in your ideas. Have you already considered how to use their knowledge and experience? Thiink of a crowd-written medical Wikipedia meets paleo/functional medicine in an evidence-based forum–something like a Functional Medicine Academy. I think it would be helpful just to know all the different ideas people are learning about and researching and bring to together in a central knowledge and idea-sharing/discussing setting.
    Chris

  5. I’m really looking forward to your upcoming education programs! As a physician assistant, it would awesome if a) the programs offer CME and b) are affordable. The IFM trainings are so expensive, which has been the limiting factor for me. I’ve learned so much from your website and podcasts. I love your perspective and approach to medicine. I’m really looking forward to learning more from you about clinical application. Thanks for all your hard work!

  6. I am very interested in your training. I’ve graduated from the Institute for Integrative Nutrition, and I’m currentely working as a health coach in Beirut, Lebanon.
    Would I be eligible for that course?

  7. Just want to mention that Metabolic Typing is the science of how ancestral genetic phenotypes influence dietary requirements as humans adapted to many different environments and Paleo encompasses all of those unless dogma says we stopped evolving at a certain point before we migrated to different climates ecosystems and environments. Metabolic Typing is intimately connected with the Functional Diagnostic Nutrition course put together by Reed Davis. It is an amazing course and u don’t need a liscense to run the functional testing we do. But no matter I bet ur course is going to be amazing too and I know I could learn so much from u as I do already. Unfortunately I don’t have an approved state recognized liscense or I would saving my money to attend this course lol.

  8. Hello Chris. Very interesting information about the functional medicine education. I am a medical doctor, pediatrician and pediatric cardiologist form Colombia. In my every day practice I am seeing lots of children and adolescents with chronic diseases. Because of this I am very interested in a functional approach to my patients.
    I hope it comes out very fast.
    For medical doctos out-side the States, what requiquisites would you need?

  9. I am thrilled and excited after viewing the podcast! I am an NP (14 years/strong background in preventative cardiology), wellness coach and a strong interest in functional medicine! Thus may be quite fortuitous as I want to learn more than I already do about the role of nutrition and wellness!

  10. Hi, I’m very interested in your training programme. I’ve studied Acupuncture at The College of Integrated Chinese Medicine in Berkshire UK for three years and I am now studying to become a Nutritional Therapist, the course allows me to gain insurance with the Federation of Nutritional Therapy Practitioners in the UK. Would I be eligible? I look forward to hearing from you, Dulcie.

  11. Hey Chris,
    Awesome to hear that you are starting a course, I have been following your work for years now, read all your books and am a big big fan.
    Im a certified Functional diagnostic Nutritionist with a BSc from University of Sunshine Coast Queensland Australia. Would my FDN and BSc make me elidgable to start your course?

  12. Chris, I have been following you since your Healthy Skeptic blog, and was excited then whenever you mentioned that you were thinking about creating a training for your approach. Unable to wait for whenever that might be realized, I enrolled in University of Western States’ MS in Human Nutrition and Functional Medicine, based in Portland, OR, but entirely online. I’m currently in my second year, and learning in depth much of what you have discussed over the years. The faculty is varied, often brilliant, all clinicians/educators and the approach is fairly broad, including a mostly vegetarian approach and an evolutionary approach that values animal products. I’ve seen some fascinating discussions among my classmates in the Forums (Fora?) debating the value/ethics of omnivorous vs. plant-based nutrition. I learn tons from my classmates who are practicing clinicians covering a range of perspectives. I haven’t seen much beyond the Intro course that gives the framework you talk about, and it’s already clear to me that I need an expansion of that study, as well as the practice management piece — especially if I decide not to seek a license. I’ve considered a naturopathic license, with NCNM in Portland, but at my age and as a practicing RN, and my other love (homeopathy via the Banerji protocols — and I know how you feel about homeopathy!) I am considering a small practice without a license. Will you offer modules separately? And are you aware of UWS?

    • Hi Angela,

      I am also attending the UWS Masters in Human Nutrition and Functional Medicine program, although I have just started. I too found it frustrating looking for the right program to address Functional Medicine and Nutrition from an ancestral perspective. I like the sound of Chris’ training as a way to round out the training at UWS (to get in the ancestral perspective).

      For Chris: please consider allowing non-licensed practitioners to participate in trainings (including lab work); as a medical herbalist (with professional status with the American Herbalist Guild and with the National Institute for Medical Herbalists- UK), with additional certificate trainings, I frequently use labs when working with patients and would welcome training with your unique perspective.

  13. Awesome announcement Chris! that’s very exciting. I am currently working with function neurology (ie. kids with behavioral, academic, social etc. issues and approaching from a very progressive ground breaking way to fix these issues) as well as functional medicine to help change diet and lifestyle. I also am doing a lot of work with my wife and I on getting our bodies healthy. There is a lot of research done on how the exposome, epigenetics, and genetics are effecting the development of the brain or under development of the brain which causes neurobehavior, social or academic issues. If the brain is undeveloped or unhealthy the body will be and vice versa. This is something coming from both worlds I believe needs to be addressed. It doenst matter how much we heal our bodies if our brains are under developed than we will be in a constant sympathetic state and or organs, processing, functions will also be underdeveloped. It also doenst matter how much our brain develop if we don’t heal our insides and change diet and lifestyle we cant have a healthy body and brain. This could also be something to incorporate into your practice/work/training etc. I’d love your comments and to share more.

    • Great podcast as always. As certified health coach I work with people every day with issues such as thyroid disease, autoimmunity, hormone issues etc. I understand more than the average coach who received a basic certification b/c I have been studying for almost 15 years. I think of myself as the support and guide that these people need to make changes in food, stress, fun, exercise and sleep. I only make recommendations and never consider myself a prescriptive coach as I am diligent in confirming that they need to take everything we do to their doctor. I provide them with everything they need to learn and I have done all of the research for them on what is reliable progressive information. I am often citing you Chris and the other trailblazers as Reed, Datis K, Kelly Brogan, Diane S. Mark S etc. I can’t wait for this program to come out next year but I urge you to leave the entire thing (all modules including labs and hormones etc) to everyone. I talk about hormones and labs with every client and they seek out a primal doc or FDN and ask them for help with the information I give them. I work hard every day to learn everything I can and would hate to miss out on a lesson given by you that could sum these areas up for me. Please consider keeping this available to anyone. I understand it and would appreciate it very much.

  14. Excellent news. Your approach sounds like the best one I have ever heard (addressing environmental factors first and foremost from an ancestral viewpoint). Western medicine is way too specialized and fragmented and as such has a horrendous track record (which the statistics all demonstrate) as the fundamental issues that support HEALTH never seem to get addressed.

  15. One thing I was very sorry to see not mentioned on the topic of pursuing functional medicine as a career is that chiropractors (in most states) are also able to order labs and recommend nutritional supplements as part of our scope of practice. Manual medicine is our foundation, but many of us are interested in functional medicine, too.

    We also have a good foundation in nutrition in chiropractic school (many more hours than an MD or DO), but if you really want to get deeper into the practice of functional medicine, further study is needed. Also, DCs generally can’t prescribe medications, so anybody interested in that shouldn’t pursue a DC degree.

    One thing I love about the IFM is that it’s wonderfully inclusive of MDs, DOs, NDs AND DCs. I hope this new program you’re starting will be, too, because I really respect your work, and I know many of my fellow chiropractors do, too.

    • Thanks so much for articulating this. As a DC who practices functional medicine and having extraordinary respect for Chris Kresser and his cutting edge and extremely astute approaches to clinical thinking and applications, I was saddened by his exclusion of the chiropractic professional from this podcast. He did mention Dan Kalish and may other programs that were pioneered by DCs. Certainly hope the lack of direct recognition of the profession was not intentional.

      • That was odd DCs were left out, sounded like anyone who ever took an anatomy class was mentioned 🙂 Oh well, I’ve taken one of the functional medicine programs that was mentioned and while the amount of knowledge given was vast, there was no real protocol or system to use or implement. Looking forward to the program.

  16. Chris,

    I am so excited that you have this coming! I asked you about 4 years ago if you had a program to train with you, and you did not have anything in motion at that point. I absolutely love your work and I use your theories of food and lifestyle choices in my life and with my patients. I have seen huge transformations with just following your blogs and website. Thank you! I look forward to going through your program!

  17. I was so happy to hear this podcast!!!! I’d love to learn from you, but I still need to obtain a license in the health field. I was considering going to The Institute of Transformational Nutrition or Nutritional Therapy Association. I’d love to know if I’d qualify for your training after completing one of those programs.
    THANKS!
    Stephanie