Functional Medicine or Integrative Medicine? What to Ask Before You Choose a Doctor

The printout

A man came to see me because his wife made the appointment. He was fifty-four, he had not seen a doctor in four years, and he told me before he sat down that he was not sure any of this was real medicine.

The printout was hers. She had found three practices while looking for someone who would take a proper look at him. One called itself functional medicine. One called itself integrative medicine. The third said holistic. He had read all three websites and could not tell them apart, and what he wanted to know was whether there was any real difference between them, or whether it was the same thing with three different words on it.

That is a fair question, and it is closer to the right one than he thought it was. Then he asked the version of it I have been asked many times since. Which one of these is the right kind of doctor?

I did not have a clean answer for him. The words on that printout overlap heavily. They came from different places and they carry different histories, but on a website they blur into one another, and none of them tells you the thing you actually need to know.

So we spent his visit on a different question. Not what do these words mean, but what should I be asking the person behind them. That turned out to be a much shorter conversation, and he left with five questions instead of three names.

The printout

Functional Medicine

Root-cause medicine. We look for the why, not just the what.
Advanced testing.
A protocol built around you.

Integrative Medicine

Whole-person care. We treat the cause, not just the symptoms.
Comprehensive testing.
A plan built around you.

Holistic Medicine

Mind and body together. We find what is underneath.
In-depth testing.
A path built around you.

Three different words. Read the promises underneath them.

What the words mean, roughly

Here is my summary of the vocabulary. My own label is on this list, and it is subject to the same caution as the others.

The word	What it usually describes	What it does not tell you
Conventional	Medicine organized by organ system and by disease, with strong evidence standards and a deep bench of specialists.	How much time you will get, or whether anyone is reading your results as a whole.
Integrative	Conventional medicine combined with other evidence-informed approaches, treating the whole person rather than an isolated complaint.	The person's training. It is an approach, not a credential.
Functional	A systems-based approach that looks for the upstream causes of symptoms rather than managing them one at a time.	The same thing. It is also an approach, not a credential.
Holistic	The broadest of the four. Usually signals attention to the whole person, mind and body.	Almost anything specific.

The reason I keep writing roughly is that these words describe a philosophy of care rather than a qualification. Two practices using the same word can be doing genuinely different things, and two practices using different words can be doing almost the same thing. That is a description of the vocabulary rather than a criticism of anyone using it.

I am my own example of that. My board certification is in integrative medicine, and that is the word on my door. But the way I actually work — looking for what is upstream of a symptom rather than managing the symptom on its own — is what most people mean when they say functional. Two of those four words describe my practice accurately, and only one of them appears on my certificate.

Which is why the printout could not have helped him. It set four adjectives beside one another and asked him to choose between them.

How I got here, and what each part of it taught me

I began in neurology, which is about as specialized as medicine gets. You spend years learning one system in extraordinary detail, and it teaches you something I have never let go of: the nervous system sets the thermostat for everything else. Sleep, mood, appetite, hormones, how you handle stress, how you recover. When it is dysregulated, nothing downstream behaves.

Conventional training also taught me the habits I still practice every day. Read the evidence. Examine the patient. Know what you are looking at on a lab report and know what you are not. Know when something is outside your scope and refer, promptly, to someone who is better at it than you are.

It gave me all of that. What I still needed was room. I could see, over and over, that the person in front of me had a hormonal problem and a nutrient problem and a sleep problem and a stress load, and that these were not four separate appointments with four separate people. They were one situation. The structure I was working in was not built to treat it that way — that is how medicine is currently set up, rather than anybody's oversight.

So I went looking for training that was. I completed a fellowship in integrative medicine at the University of Arizona under Dr. Andrew Weil, who did more than anyone to establish the field in this country, and I later took board certification in integrative medicine. Along the way I added specific training in hormone therapy, then obesity medicine, then menopause. Each one came from the same place: a patient in front of me with a problem I wanted to be better at.

How I got here

Neurology — residency, then board certification in 2007.

Years spent inside one system, in about as much detail as medicine goes. It taught me the thing I have never let go of: the nervous system sets the thermostat for everything else.

Hospital practice.

Read the evidence. Examine the patient. Know your scope and refer promptly. These are the habits I still practice every day.

Integrative medicine fellowship, 2012–2014. University of Arizona, under Dr. Andrew Weil.

Training built for what I kept seeing — one situation rather than four separate appointments. I opened Meliora in 2013, before I had finished it.

Board certification in integrative medicine, 2017.

The certification followed the practice rather than preceding it.

Hormone therapy, 2014. Obesity medicine, 2024. Menopause, 2026.

Each one came from the same place: a patient in front of me with a problem I wanted to be better at.

The Meliora Method. Five systems, read together and explained to you — which is the reason all of it had to end up in one place.

I mention all of that for one reason. I am telling you where my judgment came from, so that you can decide what it is worth, rather than asking you to trust the word integrative.

What I kept from conventional medicine, and why it matters to you

People sometimes assume that a physician who practices integrative medicine has left conventional medicine behind. I have kept all of it, and I would not want to practice without it.

I still order and read real laboratory panels. I still hold to evidence, and when the evidence is thin I tell you so. I still refer, often, to endocrinologists, gynecologists, rheumatologists, cardiologists and surgeons, because a great deal of medicine belongs in more expert hands than mine.

What changed is the frame, not the rigor. I read the same results conventional medicine reads, and I read them against what is optimal for you rather than only against what is common in the population, and I read all of them together rather than one at a time.

The difference is that I am asking a wider question of the same evidence.

Patients ask me often whether I can be their primary care physician. The answer is that it is a different job, and it is worth having someone in it. Your primary is who you see for acute illness, and they order the screening that belongs to general medicine — the colonoscopy, the mammogram, the checks that happen on a schedule rather than in response to a symptom. They also handle refills for medications I did not prescribe, and the forms and clearances that need a signature from your regular physician. And if you bring me something that belongs with them, I will tell you so and point you in that direction.

The five questions I would ask

This is what he left with. The questions work on any practice, mine included.

Ask	Why it matters
1. What is your training, and what are you licensed and board certified to do?	This is the question the labels cannot answer and the one most worth asking. It is also a perfectly polite question, and most of us are glad to be asked it.
2. Can you prescribe? And will you manage my treatment, or send recommendations to someone else?	The single most useful question on this list, and the one almost nobody asks. See the next section.
3. What will you actually test, and what will you do with the results?	You are listening for a plan rather than a panel. What you want to hear is what changes depending on what comes back.
4. Who reviews my results, will you explain them to me, and how much time will I have?	Interpretation is where the work actually happens, and you should expect it explained to you rather than summarized at you. Ask whether the physician reads your panel personally, and how long your visits are.
5. What happens when something is outside your scope?	You are listening for a real answer with names in it. A practice that refers well is telling you where its edges are, and that is a good sign.

All five are about what will actually happen to you, rather than about the label.

The one that changes the most: does this doctor advise, or manage?

Question two deserves its own explanation, because the answer changes what you are buying more than any other single fact about a practice, and because it is genuinely hard to tell from a website.

Some practices review your results, interpret them, and give you recommendations to take back to your primary care physician or your gynecologist. That is consultation. It can be enormously valuable, particularly if you already have a physician you like who simply has not had time to look at the whole picture. But the person writing your prescriptions is still someone else, and they may or may not agree with the recommendations you bring them.

Other practices take over the management. They write the prescriptions, adjust the doses as your results and your symptoms change, order the follow-up labs, and carry the responsibility for what happens next.

One thing here is easy to misread. A supplement recommendation is not a prescription. A consulting practice and a managing one can both suggest supplements, and many do, so being handed a protocol tells you nothing about whether the person who wrote it can prescribe a medication for you or adjust one you are already taking.

Advise, or manage

Consultation

Someone else writes your prescriptions.

Reviews your results and interprets them

Recommends changes, supplements included

Your own physician decides what to prescribe

Your own physician orders the follow-up labs

What happens next depends on their agreement

Management

The prescribing sits with the practice you are asking.

Reviews your results and interprets them

Recommends changes, supplements included

Writes the prescriptions and adjusts the doses

Orders the follow-up labs

Carries responsibility for what happens next

Neither is better. But you should know which one you have.

Neither is better. They are different arrangements, and both are legitimate. But you should know which one you are getting, because if you think you have a treating physician and you actually have a consultant, nobody is holding the plan.

You should have my own answer as well. In my practice, prescribing and managing stay together. If I am prescribing for you, I am also the one ordering your follow-up labs, adjusting as your results change, and carrying the plan.

What I do with the answer

The reason the whole picture matters is that the systems do not take turns. Your hormones, your nutrient status, your gut, your stress physiology and your metabolism are in constant conversation with one another, and a symptom almost never belongs to only one of them. Fatigue is the obvious example. It is a thyroid symptom, an iron symptom, a B12 symptom, a sleep symptom, a blood sugar symptom and a stress symptom, and the only way to know which it is for you is to look at all of them at once.

That is what the Meliora Method organizes: five systems, read together, and explained to you rather than summarized at you. I built it as much to keep myself honest as to teach anyone else. When you have to explain your reasoning to the person it is about, you find out quickly whether the reasoning holds.

The explaining is part of the treatment. You can only follow a plan you understand, and you can only tell that something has shifted if someone has shown you what you are looking at. So I teach as I go: what the marker is, why we are watching it, and what would make me change course. Patients who understand their own results ask better questions at the next visit, and those questions make the medicine better.

And that is the real answer to the question on the printout. What matters is whether the person behind the word can tell you what they see, why it matters, and what they intend to do about it — in language you can repeat to someone else afterward.

If you take one thing

The five questions will tell you more than the adjective on the door ever will. Ask them of any practice you are considering, and ask them of me too, whenever you are ready. I would be glad to answer them.

And if your results have been called normal while you continue to feel unwell, that is worth looking at properly, whatever the practice you take it to calls itself.

The patient described here is a composite. Dr. Rowena Chua is the founder of Meliora Integrative Medicine in Evanston, IL and is triple board-certified in Neurology, Integrative Medicine, and Obesity Medicine. A longtime Evanston physician, she specializes in hormonal, metabolic, and neurological health.