Facilitated

22| Middle Medicine: Beyond Root Causes

• The Facility Denver • Episode 22

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We introduce the concept of "Middle Medicine" as an alternative to traditional functional medicine approaches that often focus too narrowly on finding a single root cause or running excessive tests without results.

• Frustration with the term "functional medicine" as it's been co-opted by practitioners who run expensive tests and prescribe supplements without understanding systems biology
• The problem with obsessively seeking a "root cause" when sometimes fixing the system matters more than identifying the trigger
• Introduction of "Middle Medicine" as an approach that combines conventional diagnostics with natural interventions
• The importance of practitioner-patient connection in diagnosis and treatment
• Working collaboratively with specialists rather than creating an "us vs. them" mentality
• Focusing on solving problems rather than adhering to a specific medical philosophy

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Stay curious, stay proactive, and we’ll catch you next time!

Speaker 1:

Welcome to Facilitated, where we bring you real stories, strategies and science from the world of functional medicine. I'm Dr Mitchell Rasmussen, a functional medicine practitioner.

Speaker 2:

And I'm Kate Daugherty, a certified nutritionist. We are the owners of the Facility, a functional medicine clinic here in Denver, Colorado.

Speaker 1:

We help people improve their biology and get out of their own way. We help people improve their biology and get out of their own way. In my view, our work is about getting to know the person with the condition much more than it's about understanding which condition the person has. As I always say, diagnose the biology, not the disease.

Speaker 2:

On this podcast we break down complex health topics, share real patient cases anonymized, of course and explore cutting-edge wellness strategies so you can make informed decisions about your health. Quick heads up before we dive in this podcast is for education and general information only. We're here to share insights, not to diagnose or treat. So if you're dealing with a health issue, chat with a qualified healthcare provider before making any changes. All right, let's get into it. All right.

Speaker 1:

What are we talking about today, Kate?

Speaker 2:

We're going to do a little shorty about middle medicine.

Speaker 1:

Middle medicine, I guess. First and foremost, I'm not a big fan of the term functional medicine. I think it's been co-opted by people who believe they're doing better, but essentially what they do is they run some tests and they give a bunch of supplements without any thought about how everything works together, and or they're obsessed with this idea of finding a root cause and you think a root cause doesn't matter I think it can matter absolutely.

Speaker 1:

I think finding ways to fix the system can sometimes happen outside of finding a singular root cause and, as I always say, everything influences everything. Finding one thing is probably not worth our time and money for most people.

Speaker 2:

Probably not realistic either One thing.

Speaker 1:

People reach out to me on Instagram. It's like those people that make posts like everyone's been asking. No, I actually get a lot of people asking I want to do a full blood panel with you and if I simply opened up the Vibrant or the LabCorp test catalog, we could spend $30,000. I could run a full-body MRI, a liquid biopsy, every sort of stool and toxin and autoimmune test in the book, and I'd still have questions and probably be lost and the patient would be broke, have questions and probably be lost and the patient would be broke and it might not even tell us the basic things that a history could tell us. So a few years ago we were sitting down with a young boy with Tourette's. I remember where it was when I first said what we do is middle medicine. They were miffed by the medical system and the mother was quite frustrated because her child was just being pumped full of certain medications without anybody actually sitting down to talk to him and I remember I even asked him why do you bark?

Speaker 1:

Because the kid made a lot of vocalizations and he actually very smart kid explained that he feels it coming and he just needs to let his energy out and I actually can resonate with that quite a bit in different ways but in that moment I connected with the child and his mother and I also saw a moment to bring her back to the middle and I said, look, we use really cool lab tests and diagnostic measures such as scans like MRIs or CT scans, but we also like to use natural interventions and lifestyle as much as possible. We refer to specialists quite often, whether they be GI doctors or neurologists or orthopedists, but we are not living in this world of us against them.

Speaker 2:

Yeah, we definitely don't pretend that we are we have all of the answers, or that we have all of the tools that we, that a patient needs and are very comfortable recognizing. Okay, here's where our expertise stops. Here's the next layer that we need will help you to navigate what to say, how to advocate for yourself, but this is the next support that you should seek out.

Speaker 1:

We work well with others. Is that what you're saying?

Speaker 2:

Yeah.

Speaker 1:

Yeah, and I make it clear from day one I am not a cardiologist. I am not a cardiologist, I am not a pulmonologist, but I believe what I am is a problem solver and a detective and I am willing to connect with you and try to connect you to your problems so that we can fight against them together. Of root cause, one of my mentors once said to me if someone throws a rock through your window and you get in your car and you chase them down and you figured out who it was that through that rock, that does not fix your window sometimes. What you need to do is just fix the window. You don't need to find who threw the rock. And that's this idea of root cause versus systems biology.

Speaker 1:

And I really feel like we are that next age of this idea of functional medicine. And that's where, someday, I'm hoping middle medicine can become more of an accepted term Because honestly, I don't, man, you can. There's a lot of bad taxi drivers, there's a lot of bad employees in all fields and I don't want to be lumped in to a lot of the people who say they practice air quote functional medicine. Would you agree with that?

Speaker 2:

Yeah, maybe we should call it Mitchell medicine.

Speaker 1:

Just a cult of personality? Chew your food? Yeah. Just because you say you do that functional medicine doesn't mean you're any good at it, and I guess we spend quite a bit of time working with people who have already air quote failed at these functional medicine clinics. We had a man who spent, he told me, over a hundred thousand dollars at all their clinics and within 10 minutes of a history we figured out the one three hundred dollar test that we needed to run on his sinuses. We found a very interesting antibiotic resistant staph infection. We referred him to an ent doctor who prescribed a compounded antibiotic for his nasal passages. And what was it about? 10 days later he was back at work and he had retired in his 20s from a very lucrative job, his dream job, and all of that air quote functional medicine aka running a hundred thousand dollars worth of tests did nothing for the young guy, but a five minute connection with him solved the problem. So that's why we need to come up with a new term Mitchell Medicine.

Speaker 2:

Taking all recommendations. Yeah, I'm open, so we're not stuck with that one.

Speaker 1:

Please somebody, yeah, but that's what again, this is kind of a convoluted discussion. A few, maybe a little soapbox here about what we are frustrated about in our field, but also we are the people that are desiring to push this field forward to advocate for people.

Speaker 2:

Great.

Speaker 1:

You know we are in a lot of ways. Our population has never been so sick and so disconnected, and continuing to dive in to find a single root cause is probably going to keep us sick.

Speaker 2:

And that's a wrap for this episode of Facilitated. If you enjoyed it, hit subscribe because, let's be honest, you'll forget otherwise. And if you really loved it, please leave us a review. Not only does it make Mitchell feel warm and fuzzy inside, but it also helps more people find functional medicine without falling into a Google rabbit hole. For more about what we do at the facility, check out our website, wwwthefacilitydenvercom. You can also follow us on Instagram at the facility Denver for extra tips behind the scenes, fun and updates on new episodes. Thanks for listening. Now go facilitate your own health and we'll see you next time.