“The Elephant and I&FM: A Parable” is an excerpt from “Higher Ground: Critical Information for Physicians Interested in Practicing Integrative and Functional Medicine (I&FM).” The full text of “Higher Ground” is available for download on e3BFM’s Premium Content site. 

The Elephant and I&FM: A Parable (A “Higher Ground” Excerpt)

In a popular Buddhist parable, a group of blind men encounter an elephant for the first time. Each man feels only one part of the elephant’s body, with each man feeling a different part, (such as the trunk, the side and the tail). The three men then describe the elephant based only on the part of the elephant that they touched. While they all felt the same elephant, their perception and understanding of that elephant differs based on their experience.

The more I have been involved with I&FM, the more I am convinced that I&FM is the elephant in the parable and that most people share the blind men’s confusion. Is preventive care I&FM? Is wellness medicine I&FM? Is sports performance I&FM? Are medical spas I&FM? Are testosterone clinics I&FM?

Something I do every now and then is to perform an online search for “Las Vegas,” “integrative” and “functional medicine.” I want to see where my wife and her practice are in the results, but I also look at which local practices are using the terms “integrative” and “functional medicine” to market their practices. The results are always interesting. Some practices promote any collaboration between types of care—such as primary care and chiropractic care—to be integrative. Some practices identify as functional because the providers are looking for the “root cause” of patient complaints.

Part of the problem is that I&FM is so ambiguous. A dozen years ago, my wife and I discussed adding a chiropractor to her family medicine practice as becoming integrative. Now, my wife would be more likely to consider a practice integrative if it addressed the energy of emotional issues. I wouldn’t necessarily identify a practice as integrative just because a medical provider and chiropractor were working together. I know our perspectives have changed, but I wonder if society’s perspective has changed as well. As what was integrative becomes part of mainstream medicine, is it still integrative?

I&FM is obviously a really, really big elephant. “Integrative,” “functional,” “integrative medicine” and “functional medicine” can be hard to define and can mean drastically different things to different people. Mainstream medicine is also moving as well, which may or may not affect what these terms mean. It could even be that in our parable analogy, the blind men have encountered multiple elephants with varying physical presentations.

So while it might make sense to define I&FM, I am going to pass. I know what I&FM means to me, but I’m not sure that has any relevance to what I&FM means to anyone else. Even with my understanding of what I&FM means to me, I always have to figure out what I&FM means to the other person any time I have a conversation about I&FM. I think I have a good understanding of the elephants I have encountered, but someone else may be talking about an elephant that is completely different when they talk about I&FM.