Functional Medicine Frequently Asked Questions
What is Functional Medicine?
Functional medicine is a science-based health care approach to assess, prevent and treat complex chronic disease. It is a new model of medicine that has evolved through the efforts of scientists and clinicians from the fields of clinical nutrition, molecular biology, biochemistry, physiology, conventional medicine, and a wide array of scientific disciplines. Functional medicine evaluates the body as a whole with special attention to the relationship of one body system to another and the nutrient imbalances and toxic overload that may adversely affect these relationships.
The vast majority of modern-day illness is not from acute illness that can be easily diagnosed and treated. Most illness is chronic and almost always preceded by a lengthy period of declining function in one or more of the body’s systems. Functional medicine is a new clinical model that replaces outdated and ineffective acute-care models of health care and attempts to return patients to wellness. Illness is addressed by identifying specific dysfunctions that have contributed to the disease state. Those dysfunctions are, for each of us, the result of lifelong interactions among our environment, our lifestyle and our genetic predispositions.
For more information, please visit the website for the Institute for Functional Medicine.
Can You Help Me With My Health Problem?
If you suffer from a chronic medical condition, if you are frequently ill, tired or in chronic pain or if you simply seek to optimize your health, Dr. Suzanne may be able to help. If you feel you are taking too many prescription drugs, want a more natural approach or wonder which supplements are right for you, Dr. Suzanne can help.
Mainstream medical practice does not focus on finding the root cause of illness. The usual medical tests do not look for food sensitivities, hidden infections, environmental toxins, mold exposures, nutritional deficiencies and metabolic imbalances. New genetic testing can uncover underlying genetic risks that can be modified through diet, lifestyle, supplements or medications.
Dr. Suzanne Fox is highly skilled in evaluating, assessing and treating chronic problems such as fibromyalgia, fatigue syndromes, autoimmune diseases, gastrointestinal illness, inflammatory disorders, mood disorders, memory problems, and other chronic, complex conditions. They also focus on the prevention and treatment of heart disease, diabetes, dementia, hormonal imbalances and digestive disorders. Please contact us if you would like to discuss whether or not we can help with your particular health condition.
Is Dr. Suzanne Fox a Primary Care Provider?
Dr. Suzanne does not provide primary care services. She will work with you closely as a consultant in preventive, nutritional and functional medicine to help you address the roots of chronic health problems. She will confer with your primary care doctor and specialist physicians if required.
What About Laboratory Testing?
Some testing can be done through conventional laboratories, and others are only available through specialty laboratories. During your medical consultation, Dr. Suzanne will determine which tests are needed and will review testing recommendations, instructions (for instance, fasting or non-fasting, etc.) and costs.
Your financial resources and how much testing you want to do are taken into account, and the plan for testing is reviewed with you. Testing is frequently done to assess nutritional status, including amino acids, fatty acids, oxidative stress, vitamin levels, mitochondrial function, food sensitivities, and heavy metals. Many other tests are available including genetic testing for a variety of conditions, hormone evaluations, bone health, gastrointestinal health, adrenal function and many others.
Some testing can be performed at home with test kits to collect urine, saliva or stool. Others may require a blood draw. In all cases, we will assist you in coordinating initial and follow-up testing.
Do You Take Health Insurance?
Triangle Alternative Medicine operates as a self-pay clinic. Our office does not bill your insurance directly, but we will provide you with a coded receipt for services, which you may submit for reimbursement to your insurance carrier. Dr. Suzanne Fox is out-of-network providers for all private insurance plans and does not participate with Medicare. The amount of reimbursement you receive depends on your insurance plan’s reimbursement policy for out-of -network providers, your deductibles, copay’s and co-insurance. You may wish to check with your insurance plan regarding out-of-network coverage of services prior to your visit with us.
Services associated with our clinic including nutritional counseling, supplements and laboratory testing can be submitted under your health savings account (HSA), flex Spending Account (FSA) or Healthcare Reimbursement Account (HRA).
Why Do You Not Accept / Bill Insurance?
Dr. Suzanne strongly believes in the medical care that she provides, and she strives to deliver high quality care to as many people as possible. She understands the financial challenge that her not filing insurance may present for some patients. Reimbursement rules from health insurance companies can be confusing for both doctors and patients. Her rationale for not accepting insurance reimbursement is outlined below. If after reading this you still have questions please feel free to call and speak with our staff.
The current system of mainstream medical care does not meet the health care needs of many patients. There are many reasons for this, including the policies set forth by health insurance companies. When doctors agree to participate with insurance companies, including Medicare and Medicaid, they must sign a contract that allows the insurance company to determine which services they will and will not provide and how much they can charge for those services. A doctor must agree to these fees regardless of whether they are applicable or reasonable. In general, insurance companies reimburse for procedures, drugs and surgeries with little reimbursement allowed for physical examination, detailed medical history review and preventative medicine counseling. Most general medicine doctors and clinics cope with this flawed reimbursement scheme by keeping their office visits very brief so that they can see many patients in a given day. The average primary care provider sees between 20 and 30 patients a day and spends 1 to 2 hours a day completing additional paperwork to obtain reimbursement for services rendered. Unfortunately, many physicians still struggle to cover expenses, given the deeply discounted reimbursement allowed by insurance companies for primary care services. As a result, primary care providers must often merge with large practices or hospitals that offer high-tech surgical and diagnostic procedures with their higher reimbursement rates simply to stay afloat.
Many patients and doctors are frustrated with the extremely brief office visits that are the current norm for mainstream medicine. Dr. Suzanne has found that she cannot participate with insurance networks, including Medicare and Medicaid, and still provide expert, well-researched, time-intensive medical care for her patients.
Do You Sell Nutritional Supplements?
Yes, Dr. Suzanne often recommends nutritional supplements to patients in conjunction with lifestyle and dietary modification. In some cases, nutritional supplements can be used in place of more toxic prescription medications. Dr. Suzanne relies on scientifically based studies to guide her therapeutic decisions regarding nutritional supplementation. She has researched high-quality nutritional products and carries only those products that undergo rigorous quality testing by nutritional research laboratories. These products are often of higher quality than those sold over the counter and are free of fillers, allergens and additives.